Think of your red blood cells as the transport system that carries oxygen to your body’s tissues. When you have anemia, your body doesn’t make enough red blood cells, or these cells don’t work as well as they should. You end up feeling weak, tired, and short of breath.
Anemia comes in many forms. Iron-deficiency anemia is most common. Other types of the disease affect only small numbers of people. Here’s a look at some of the rare types of anemia and how they’re treated.
Aplastic (or Hypoplastic) Anemia
You’re either born with aplastic anemia, meaning you inherited a gene from your parents that caused it, or you develop it (acquired). Acquired aplastic anemia is the more common of the two, and sometimes it’s only temporary.
Acquired causes include:
- Autoimmune diseases such as lupus and rheumatoid arthritis
- Chemicals such as pesticides, arsenic, and benzene
- Infections including hepatitis, Epstein-Barr virus, and HIV
- Radiation and chemotherapy treatments for cancer
Inherited conditions such as Fanconi anemia, Shwachman-Diamond syndrome, and Diamond-Blackfan anemia, can damage cells and also cause aplastic anemia.
- One way to treat aplastic anemia is with a blood transfusion. You’ll get a donor’s blood through a vein. A stem cell transplant also treats aplastic anemia. It replaces the damaged stem cells in your bone marrow with healthy cells.
In this group of blood disorders, your body can't use iron to make hemoglobin -- the protein that carries oxygen in your blood. Iron builds up and forms abnormal red blood cells called sideroblasts.
There are two main types of sideroblastic anemia:
Acquired sideroblastic anemia is caused by exposure to certain chemicals or drugs.
Hereditary sideroblastic anemia happens when an X-linked recessive gene mutates and disrupts normal hemoglobin production. This gene produces “heme,” the part of hemoglobin that carries oxygen.
Symptoms for both types include:
Treatment for sideroblastic anemia depends on the cause. If you have acquired anemia, you'll need to avoid the chemical or drug that caused it. Other treatments include vitamin B6 therapy, folic acid, and bone marrow or stem cell transplants.
Some people are born with a gene that causes MDS. These genes are usually passed down from one or both parents. If you have certain inherited syndromes, including Fanconi anemia, Shwachman-Diamond syndrome, Diamond Blackfan anemia, familial platelet disorder, and severe congenital neutropenia, you could be more likely to develop MDS.
Some people don’t have symptoms with MDS, but others do, including many of the same symptoms of anemia:
Autoimmune Hemolytic Anemia
Autoimmune hemolytic anemia happens when your body's immune system attacks and destroys red blood cells faster than it can make new ones.
If you have an autoimmune disease like lupus, you’re also more likely to get this type of anemia. Medicines such as methyldopa (Aldomet), penicillin, and quinine (Qualaquin) can also cause autoimmune hemolytic anemia.
Symptoms are similar to other types of anemia, and include fatigue, pale skin, fast heartbeat (tachycardia), trouble breathing, chills, backache, and yellow skin (jaundice).
Treating the disease that caused the anemia can also stop your red blood cell damage. If you have an autoimmune disease, your doctor might treat you with steroid drugs to calm your immune system, which can help the anemia.
Congenital Dyserythropoietic Anemia (CDA)
CDA is a group of inherited anemias that reduce the number of healthy red blood cells in the body. All CDAs are passed down through families.
There are three types of CDA, types 1, 2, and 3. Type 2 is the most common and type 3 is the rarest. Symptoms include chronic anemia, fatigue, yellow skin and eyes (jaundice), pale skin, and missing fingers and toes at birth.
Some people never need treatment. But depending on the severity of the disease, your doctor might recommend a blood transfusion, a stem cell transplant, or treatment with interferon alfa (Intron A), a drug typically used for treating leukemia, melanoma, and non-Hodgkin’s lymphoma.
If you have Diamond-Blackfan anemia, your bone marrow doesn't make enough red blood cells. Doctors think it is caused by changes to your genes.
Symptoms of Diamond-Blackfan anemia include:
- Fast heartbeat (tachycardia)
- Heart murmur
- Pale skin
- Short height
- Weak bones
Treatments include everything from steroids that can help produce more red blood cells to red blood cell transfusions and bone marrow transplants.
With this type of anemia, your bone marrow produces abnormally structured red blood cells that are too large and too young. Because they’re not mature or healthy, they can't carry oxygen throughout your body very well.
Megaloblastic anemia is caused by too little vitamin B12 (cobalamin) or vitamin B9 (folate). Your body needs these vitamins to make red blood cells.
Some people with megaloblastic anemia might not have symptoms for many years. But once symptoms do appear, they’re similar to other types of anemia, and include:
- Dizziness and fatigue
- Diarrhea, nausea
- Fast or irregular heartbeat (tachycardia)
- Muscle pain or weakness
- Pale skin
- Trouble breathing
Doctors treat megaloblastic anemia with vitamin B9 and vitamin B12 supplements to replace what your body is missing. You'll also need treatment for any disease -- such as Crohn's -- that caused your body to lack these vitamins.
Fanconi anemia makes your blood marrow produce too few blood cells. It's hereditary, meaning it’s passed down from one of your parents through a gene mutation.
Symptoms of Fanconi anemia include:
If you have Fanconi anemia, you’re more likely to get a type of cancer called acute myeloid leukemia, or AML. Your odds of getting cancers of the head, neck, skin, GI tract, or genitals also go up.
Treatment depends on several factors, including what stage it’s in and the severity of physical complications. But most include hormonal therapy to increase red blood cell production and stem cells to boost white blood cells.
If symptoms become severe, your doctor might recommend a bone marrow transplant. Oftentimes a bone marrow transplant can cure the problems altogether.