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Treatment of WAIHA

Therapy is usually first aimed at treating any underlying disorders, if present. Treatments for WAIHA that may be considered include:
  • Corticosteroids such as prednisone may be used to stabilize the hematocrit. The exact mechanism of prednisone treatment is not completely understood, but theories include the reduction of antibody synthesis, altered antibody activity, and alteration of macrophage receptors for IgG and C3.
  • Intravenous immunoglobulin (IVIG) has also been shown to be effective in patients who do not respond to corticosteroid therapy.
  • If steroid therapy fails or the need for high-dose steroid therapy persists, splenectomy is recommended. Splenectomy has been shown to reduce antibody production and it removes a site for RBC destruction.
  • The last resort is immunosuppressive drugs. These drugs have detrimental side effects, including increase susceptibility to infection, infertility, and risk of birth defects.