To expose a correct diagnosis, external examination of the patient is not enough. In addition to collecting an anamnesis, blood will be required. A blood test indicates an increase in ESR, also shows reticulocytosis, normo- or hypochromic anemia, an increase in the level of bilirubin in the blood. In this case, the level of hemoglobin and erythrocytes decreases.
You must definitely pass urine for analysis. It will reveal a protein, an excessive amount of hemoglobin and urobilin.
The patient is also referred for ultrasound examination of internal organs with examination of the liver and spleen.
If the obtained data is not enough to make a correct diagnosis, then bone marrow collection is necessary, for which it is performed by puncture. After studying the obtained material, it will be possible to detect hyperplasia of the brain tissue, which occurs due to the activation of erythropoiesis. A similar goal, like a bone marrow puncture, is pursued by a diagnostic procedure called trepanobiopsy. However, it is more difficult to tolerate by patients, so it is rarely used.
The direct Coombs test for autoimmune anemia will be positive. However, if negative results are obtained, exclude autoimmune anemia is not possible. This is often observed against the background of hormonal treatment or with too intensive hemolysis.
Immunoenzyme analysis allows us to identify the class and type of immunoglobulins that participate in the autoimmune reaction.
Treatment of autoimmune anemia
Treatment of anemia of autoimmune nature is most often a long one and does not always end with complete recovery of the patient. First, you need to determine the reasons that led to the fact that the body began to destroy its own red blood cells. If the etiological factor can be identified, then efforts should be directed to its elimination.
If the cause remains unset, that is, the diagnosis sounds like “idiopathic autoimmune anemia”, then the patient is prescribed drugs from the group of glucocorticosteroids. The drug of choice is Prednisolone. If the course of anemia is severe and the hemoglobin level in the blood drops to 50 g / l, it is impossible to do without a red blood cell transfusion.
Detoxication of the blood is performed in order to withdraw the products of the decomposition of red blood cells from it and improve the person’s health. Plasmapheresis makes it possible to reduce the level of antibodies that circulate in the bloodstream. Mandatory symptomatic treatment. To prevent the development of DIC syndrome, the patient is prescribed indirect anticoagulants. To support the hematopoiesis system, the introduction of vitamin B12 and folic acid is indicated.
If you manage to cope with the disease, then the therapy ends. When after some time, autoimmune anemia occurs again, the patient is referred for an operation to remove the spleen. This will prevent the development of hemolytic crises in the future, since it is the spleen that is the “cemetery” for red blood cells in the human body. To complete recovery, this procedure leads quite often, approximately in 74-85% of cases.
Immunosuppressive therapy is an extreme measure in the treatment of autoimmune anemia, which is resorted only in the case when splenectomy does not achieve the desired results . Prophylaxis and prognosis of the disease
In order to prevent the development of anemia, it is necessary to direct efforts to prevent the infection of a person with dangerous viruses that can provoke the disease. If anemia has already developed, then minimize the impact on the body of those factors that can cause it to exacerbate, for example, avoid high or low temperatures.
Prevent the development of idiopathic anemia, as its causes are unsettled.
If the patient has at least once suffered an episode of autoimmune anemia, then the next two years he must donate blood for a general analysis. Do this with a periodicity of 3 months. Any symptoms that may indicate a developing anemia should be immediately evaluated by a doctor.
. As for the prognosis, idiopathic anemia is more difficult to treat. Complete recovery after passing the hormone course can be achieved no more than 10% of patients. However, the removal of the spleen increases the number of people who have recovered to 80%. Immunosuppressive therapy for patients is difficult to transfer, this treatment negatively affects immunity and causes multiple complications. The success of treatment largely depends on the factor that caused the development of anemia.