Autoimmune hemolytic anemia is one of the most common causes of acquired hemolytic anemia and can be caused by two types of antibodies - IgG or IgM. There are two main types: warm autoimmune hemolytic anemia, which has various potential causes like infection or underlying conditions, and cold autoimmune hemolytic anemia caused by IgM antibodies against red blood cells leading to symptoms on cold exposure. Both types result in anemia and can be diagnosed through laboratory tests showing signs of hemolysis and the presence of antibodies, and treatments aim to avoid triggers and suppress the immune system response.

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