Hemolytic anemia

1. AUTOIMMUNE
HEMOLYTIC ANEMIA

2. • One of the most common causes of acquired
hemolytic anemia.
• Two types of antibodies are involved:
IgG (warm agglutinins)
IgM (cold agglutinins)

3. WARM AUTOIMMUNE HEMOLYTIC
ANEMIA

4. Causes:
• Idiopathic: most frequently.
• Viral infection: HIV & infectious mononucleosis
• Patients with SLE, rheumatoid arthritis, Scleroderma,
Dermatomyositis & Ulcerative colitis.
• Chronic lymphocytic leukemia & non-Hodgkin
lymphoma.
• Drugs:

6. Clinical picture:
• Varies greatly with the amount and
effectiveness of causative antibody ranging
from no symptoms to life threating clinical
syndrome.
• Clinical picture of underlying causes
associated.

7. Complications
• Lymphoproliferative disorders: 18% of
patients with Idiopathic AIHA.
• Venous thromboembolism: described in
adults with Idiopathic AIHA, patients with
underlying HIV, antiphospholipid and lupus
anticoagulant +ve patients.

8. Lab. findings:
• Normocytic normochromic
anemia
• Blood film: spherocytes
• Increased serum LDH,
indirect hyperbilirubinemia
• Reduced Haptoglobin.
• Reitculocytosis.
• +ve Direct coombs.
• Thrombocytopenia (Evan’s
Syndrome)

9. Treatment:

10. COLD AUTOIMMUNE HEMOLYTIC
ANEMIA

11. • Cold agglutinin disease typically characterized
by the presence of IgM antibodies directed
against RBC membrane.
• They are produced either in response to
infection or by neoplastic growth of a single
immunocyte clone.

12. Clinical manifestations
• Symptoms and signs of
anemia.
• Changes on exposure to
cold: Livedo reticularis
and Acrocyanosis.
• Infection.

13. Lab. Findings:
• Presence of high titer of cold agglutinins.
• +ve direct coombs.
• Additional diagnosis of mycoplasma infection,
infectious mononucleosis or lymphoma.

14. Treatment
• Avoidance of cold.
• Cytotoxic agents.
• Rituximab.
• Plasmapharesis.

15. Thank you