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Autoimmune hemolytic anemia (AIHA) comes with a wide range of symptoms, one of which is jaundice, or yellowing of your skin and eyes. Jaundice is not uncommon in people with AIHA. Although there is not a lot of data on how common AIHA is in adults, one study estimated that around 60 percent of children with AIHA have jaundice.
AIHA is a condition in which immune system proteins called antibodies mistakenly attack healthy blood cells. Jaundice related to AIHA can be alarming and bothersome, but, fortunately, it can be managed.
Generally, the term “jaundice” means yellowing of the skin, whites of the eyes, or tongue. The condition looks different on various skin tones and can be less noticeable on darker skin.
Jaundice can have different causes beyond AIHA, including hepatitis, gallstones, and tumors. It results from the high levels of a yellow pigment called bilirubin, which forms when red blood cells are broken down.
In adults, jaundice doesn’t usually require treatment. However, managing the underlying cause of jaundice can reduce its severity.
In addition to the typical yellow skin color, people with jaundice can have the following symptoms:
Many people assume that jaundice is caused exclusively by liver problems. However, this usually isn’t the case for people with AIHA.
Jaundice can occur in warm AIHA, which is the most common type of AIHA. This condition affects the subset of antibodies that are most active at normal body temperature. In contrast, cold AIHA affects other types of antibodies — the ones that kick in when your body cools down.
In warm AIHA, your immunoglobulin G (IgG) antibodies mistakenly attack your red blood cells and carry them to your spleen, which destroys them. This breakdown of red blood cells, called hemolysis, releases the protein hemoglobin, the main component of these cells. The hemoglobin can then convert into a yellow pigment called bilirubin. High levels of bilirubin cause jaundice.
In addition to causing jaundice, this buildup and breakdown of red blood cells may cause your spleen to enlarge. A health care provider will be able to spot this as part of a physical exam.
Sometimes, a liver condition that can cause AIHA may also lead to jaundice. One such condition is hepatitis C, which is caused by a virus that attacks the liver. Jaundice is the main symptom of this condition. A study of more than 120,000 people with hepatitis C found they were 2.8 times more likely to develop AIHA than the general population.
A condition called primary sclerosing cholangitis — which causes long-term inflammation of your liver’s bile ducts — can also cause jaundice. Although it’s rare for people to have both AIHA and sclerosing cholangitis, it does happen.
Some medications can also cause hemolytic anemia and, subsequently, jaundice. Among them is a class of antibiotics called cephalosporins, the most common cause of drug-induced hemolytic anemia.
If you’ve been diagnosed with AIHA and suddenly develop jaundice, make sure to get immediate medical attention. Doctors will run blood tests to determine whether medications, another condition, or AIHA are to blame.
Because jaundice is a symptom of AIHA, doctors manage it by treating AIHA itself. AIHA can be secondary (caused by another condition) and primary or idiopathic (when it’s unknown what the cause is).
If you have secondary AIHA, your doctor will likely treat the underlying cause, for example, infections or tumors. Primary AIHA, on the other hand, can be treated with:
Fortunately, AIHA and its symptoms — including jaundice — can be cured in most cases. In fact, many people may not need treatment, or their treatment can be minimal. Only about 20 percent to 30 percent of people with AIHA need medications, surgery, or blood transfusion.
If your doctor prescribes medications for your AIHA, make sure to follow the treatment plan as instructed. Otherwise, the condition can come back or worsen. It’s also important to let your doctor know of any side effects or new symptoms you might notice.
AIHA can be fatal if left untreated. Get immediate medical attention if you develop jaundice or other symptoms of AIHA.
Some websites list home remedies for treating jaundice — but those generally apply to jaundice caused by liver disease. It’s best to speak with your doctor about what you can do at home for jaundice related to AIHA.
MyAIHATeam.com is the social network for people with AIHA and their loved ones. On MyAIHATeam, members come together to ask questions, give advice, and share their stories with others who understand life with AIHA.
Have you or a loved one had jaundice caused by AIHA? How did you manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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Richard LoCicero, M.D.
has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network.
Learn more about him here.
Olga Askinazi, Ph.D.
is a biomedical scientist, clinical educator, and health writer.
Learn more about her here.
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