Question: My father has anemia. As a result of research, it was understood that this was due to the antibodies made by the body. Can this disease be treated? Will it pose a risk to my father in the future?
Answer: The anemia you describe in your father is what is known in medicine as ‘autoimmune hemolytic anemia’. In this case, the antibodies formed in the body – which are of protein structure – combine with the red blood cells and cause their destruction. Anemia occurs even though the patient does not have any bleeding and does not have iron or vitamin deficiency.
The most important sign of the destruction of red blood cells in the body in a person is the outflow of substances in the red blood cells, that is, the increase in bilirubin levels. To compensate for the destruction, the bone marrow starts to work rapidly and young cells are given to the blood. In the presence of this clinical picture, hemolytic anemia should be suspected. Red blood cell destruction is seen in various blood diseases. Some of these are hereditary. Whether the destruction of red blood cells is due to antibodies can be determined by a method called the ‘Coombs’ test. If this test is positive, it means that the destruction occurs due to immunological reasons, that is, due to antibodies. The situation with your father also fits this.
Antibodies can arise for a variety of reasons. Connective tissue diseases such as systemic lupus, infections, lymphoma, diseases arising from lymphatic tissue such as chronic lymphocytic leukemia, ovarian cysts, some cancers and drugs can cause anemia by causing antibody formation in the body. Despite all the research, cases where no factor can be found are also quite common.
Whether this disease will recur or not, what kind of course it will follow depends on the underlying causes. If the drug is suspected as the causative agent of the disease, the drug should be discontinued. If there is an infection, it should be treated. If there is destruction due to lymphoma, leukemia or cancer, these diseases should be fought. Meanwhile, cortisone type drugs are used to stop the destruction in a short time. This drug ensures the elimination of antibodies. With this, successful results are obtained. Urgent blood transfusion may be required in cases where the blood drops too quickly. There is a dilemma here: The red blood cells you give can also be destroyed by the antibodies and cause undesirable results. For this reason, red blood cells should be washed in a blood bank and given in a controlled manner before use in order to prevent mutual interaction.
Prof. Dr. Coşkun Tecimer
