Autoimmune hemolytic anemia (AIHA) occurs when antibodies directed against the person’s own red blood cells (RBCs) cause them to burst (lyse), leading to. Autoimmune hemolytic anemia (AIHA) is an uncommon disorder characterized by hemolysis mediated by autoantibodies directed against. Autoimmune hemolytic anemia is characterized by shortened red blood cell survival and a positive Coombs test. The responsible autoantibodies may be either.

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Autoantibodies with such specificity are designated collectively as Rh related [ 3233 ].

The Clinical Pictures of Autoimmune Hemolytic Anemia

Incidence, long-term serologic findings, and clinical significance. Specificity of acquired haemolytic anaemia autoantibodies and their serological characteristics. In conclusion, the improvement of drugs enabled more stratified approach for patients with first-line corticosteroid-refractory AIHA.

Dausset J, Colombani J. Postinfectious forms of paroxysmal cold hemoglobinuria cease spontaneously within days to weeks after onset [ 1112 ], although the Donath-Landsteiner antibody may persist in low uemolitik for several years [ 2 ].

Diabetes mellitus type 1 Hashimoto’s thyroiditis Multiple sclerosis Coeliac disease Giant-cell arteritis Postorgasmic illness syndrome Reactive arthritis.

In cryopathic hemolytic syndromes, cold-reactive autoantibodies exhibit affinity for RBCs optimally at temperatures below body temperature.

Salama, with kind permission of the patient. Three mechanisms are recognized and two of these involve elements of autoimnu, in which autoimin recognize and bind to specific RBC epitopes in concert with drugs or their metabolites or in which the autoantibody binds to RBC epitopes without the presence of drug [ 7 ].


Nathan D, Oski F, editors.

Diagnosis and treatment of autoimmune hemolytic anemia: classic approach and recent advances

The red auotimun eluate typically indicates panreactive warm IgG autoantibody. In the absence of an underlying disease, the AIHA is termed primary or idiopathic. The serologic nature of the autoantibody helps distinguish warm antibody AIHA from cryopathic syndromes.

As with other hemolytic anemias, the severity of symptoms depends upon the rate of hemolysis, which may be slow and mild or rapid and severe.

Antibodies that react with intrinsic red cell antigens are serologically indistinguishable from autoantibodies, whereas antibodies that react against red cell-bound drug require the drug for hemolysis. Exacerbation of autoantibody-mediated hemolytic anemia by viral infection. New insights into childhood autoimmune hemolytic anemia: In paroxysmal cold hemoglobinuria, constitutional symptoms are prominent during a paroxysm. In this case, splenectomy hemoliitik be considered, as well as other immunosuppressive drugs.

Diagnosis and treatment of autoimmune hemolytic anemia: classic approach and recent advances

Immune Destruction of Red Blood Cells. Other patients with established lymphoproliferative disorders may develop cold agglutinin disease as a manifestation of the lymphoma. Patients with more severe disease symptomatic anemia, transfusion dependence may be treated with rituximab.

RBC autoagglutination may be seen hfmolitik the blood film and in chilled anticoagulated blood from patients with cold-antibody AIHA fig. Hereditary aspects of autoimmune hemolytic anemia; a retrospective analysis. Detailed characterization of autoantibodies is important, as there is a relationship between in vivo hemolysis and strength of DAT; red cell bound multiple immunoglobulins, immunoglobulin G subclass and titer.

Associated with lymphoproliferative disorders e.


Patients may present with one or both types of autoantibodies; if both are present, the disease is termed “mixed-type” AIHA. IgG antibodies are relatively poor activators of the classical complement pathway, but are easily recognized by the phagocytic cells.

Although RBC transfusion is not a contraindication in AIHA, however its use should be limited to cases of life-threatening anemia or a high risk of cardiac or cerebrovascular ischemic events. Garratty in also found that washing the patient’s red cells with ice cold saline, preferably in a refrigerated centrifuge, helps to keep low-affinity IgG bound to the RBCs. The resulting alloantibodies show no reactivity towards autologous red cells.

However, based on the belief that increased oxygen-carrying capacity provided by the transfused RBCs may be enough to satisfy patient’s oxygen need until other treatment options become effective, RBC transfusion still has its clinical benefit as a supportive treatment option especially in patients with symptomatic cardiovascular diseases in which sufficient oxygen supply is important.

Autoimmune hemolytic anemia: From lab to bedside

Postinfectious cold agglutinin disease is usually self-limited, with recovery occurring in a few weeks. The interaction between human monocytes and red cells. Autoimmune hemolytic anemia AIHA occurs when antibodies directed against the person’s own red blood cells RBCs cause them to burst lyseleading to an insufficient number of oxygen-carrying red blood cells in the circulation.

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