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autoimmune hemolytic anemia

see hemolytic anemia Etiology: - autoantibody-mediated hemolytic anemia - warm autoimmune hemolytic anemia - chronic lymphocytic leukemia [2,5] - common variable immunodeficiency [7] Epidemiology: - affects both children & adults Pathology: - autoantibodies react with all erythrocytes, including donor erythrocytes [2] Laboratory: - direct antiglobulin test - a completely cross-match compatible unit may be difficult to find [2] Management: - see warm autoimmune hemolytic anemia - prednisone or immunosuppressants - transfuse with ABO & Rh type-specific incompatible blood if transfusion indicated [2] - donor erythrocytes, although cross-match incompatible, will still survive for days to weeks - major complication is failure to identify significant alloantibody (unlikely if patient has not been previously transfused)

Related

cold agglutinin syndrome (primary cold agglutinin disease)

Specific

cold antibody autoimmune hemolytic anemia warm autoimmune hemolytic anemia

General

hemolytic anemia autoimmune disease

References

  1. Michel M Classification and therapeutic approaches in autoimmune hemolytic anemia: an update. Expert Rev Hematol. 2011 Dec;4(6):607-18 PMID: 22077525
  2. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
  3. Lechner K, Jger U. How I treat autoimmune hemolytic anemias in adults. Blood. 2010 Sep 16;116(11):1831-8. Review. PMID: 20548093 Free Article
  4. Barcellini W. Immune Hemolysis: Diagnosis and Treatment Recommendations. Semin Hematol. 2015 Oct;52(4):304-12. Review. PMID: 26404442
  5. Molica S, Polliack A. Autoimmune hemolytic anemia (AIHA) associated with chronic lymphocytic leukemia in the current era of targeted therapy. Leuk Res. 2016 Nov;50:31-36. Review. PMID: 27657651
  6. Rothaus C NEJM Resident 360. Aug 14, 2019 https://resident360.nejm.org/clinical-pearls/autoimmune-hemolytic-anemia
  7. NEJM Knowledge+