Autoimmune hemolytic anemia (AIHA) is a rare autoimmune blood disorder that occurs when the body mistakenly attacks red blood cells. Like other autoimmune disorders, AIHA results when your own immune system makes autoantibodies (antibodies that attack healthy cells).

In the case of AIHA, red blood cells (RBCs) are destroyed through a process called hemolysis. This can lead to anemia — a low amount of RBCs, which are responsible for carrying oxygen from your lungs to the rest of your body.

Fortunately, AIHA can be managed, but it is potentially fatal if not treated. Continue reading to learn about the common symptoms of AIHA.

What Are Symptoms of AIHA?

There are two main classifications of AIHA — warm AIHA and cold AIHA. The two cold types are cold agglutinin disease and paroxysmal cold hemoglobinuria.

Often AIHA may occur without an obvious underlying condition (idiopathic AIHA or primary AIHA). When AIHA is connected to other conditions, such as autoimmune diseases (like lupus), medications, or underlying blood cancers (such as leukemia or lymphoma), the disease is called secondary AIHA.

General AIHA Symptoms

Although some people have “silent” AIHA and are asymptomatic, the disease can cause a wide range of symptoms. Many symptoms occur because people with AIHA do not have enough red blood cells to carry oxygen throughout their bodies.

General symptoms of AIHA symptoms are similar to those of anemia, including:

• Low-grade fever
• Fatigue
• Lethargy (decreased alertness)
• Weakness or dizziness
• Heart palpitations (irregular heartbeat) or rapid heartbeat
• Shortness of breath or difficulty breathing
• Paleness
• Dark urine
• Fainting
• Confusion

Pain Symptoms

Some people with AIHA may experience more painful symptoms, including:

• Painful fingers or toes
• Discomfort swallowing cold liquid
• Chest pain
• Headache
• Muscle soreness

Skin Signs

Skin signs of AIHA may be present in people with more severe cases:

• Pale skin
• Jaundice (yellowing of the skin and whites of the eyes)
• Bluish or reddish fingers, toes, ankles, or wrists
• Dark purple-to-gray fingertips, nose, or ears
• Sweating
• Necrosis (areas of dying skin)

Common Warm AIHA Symptoms

Symptoms may be different for people who have warm AIHA than for those with cold AIHA. Common warm AIHA symptoms include:

• Fatigue
• Dizziness
• Jaundice
• Heart palpitations

Common Cold AIHA Symptoms and Signs

People with cold AIHA may have the following symptoms:

• Fatigue
• Dizziness
• Jaundice
• Chest pain
• Pain in the backs of the legs
• Raynaud’s phenomenon, which is often caused by exposure to cold
• Heart problems (arrhythmia — a problem with the heartbeat’s rate or rhythm — or heart failure)

Getting Help for Symptoms of AIHA

If you have symptoms associated with anemia, such as fatigue, weakness, jaundice, or shortness of breath, make sure that you schedule an appointment with your health care provider. Your doctor may want to run tests to determine the cause of your symptoms. Because many symptoms of AIHA are general and may be associated with a wide range of other health conditions, blood tests will help your physician rule out other possible causes.

The AIHA symptoms you experience can determine the specific treatments you are offered. Many therapeutic options are available that can help reduce symptoms and improve your quality of life.

Read more about treatments for AIHA.

Condition Guide

• Exploring Autoimmune Hemolytic Anemia Treatment Options
• What Causes AIHA?
• What Are the Different Types of AIHA?
• How Is AIHA Diagnosed?
• What Is AIHA? An Overview of Autoimmune Hemolytic Anemia
• Conditions Related to AIHA: What You Should Know