Warm and cold autoimmune hemolytic anemia for Lab.students

1. Warm Autoimmune hemolytic anemia (WAIHA)
Cold Autoimmune hemolytic anemia (CAIHA)
Autoimmune haemolytic anaemia
Developed by-Dr.Abdulrazzaq Othman Alagbare
M.D M.S.c C.P - Lecturer of Hematology and Immunohematology
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3. ANEMIA -Dr.Alagbare
Introduction
Autoimmune haemolytic anaemia (AIHA) may be divided in to 'warm'
and 'cold' types, according to at what temperature the antibodies best
cause haemolysis.
It is most commonly idiopathic but may be secondary to a
lymphoproliferative disorder, infection or drugs .
AIHA is characterized by a positive direct antiglobulin test (Coombs'
test)
Autoimmune haemolytic anaemia

4. Warm Autoimmune hemolytic anemia (WAIHA)
Classification Warm Autoimmune hemolytic anemia (WAIHA)
Account 70% of AIHA.
it is more common among women.
Antibody Coating
RBC
IgG
Cause extravascular hemolysis
Temperature In warm environment ≥ 37° C.
auto Ab attach to RBC and destroy them.
Direct Coombs Test Positive direct Combs' test.
Etiology idiopathic , secondary to lymphoproliferative disorder
etc
ANEMIA -Dr.Alagbare

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6. Warm Autoimmune hemolytic anemia (WAIHA)-
Diagnosis
CBC result Sever anemia
MCHC.> 37%
Increase reticulocytes
Blood Film 10% spherocyte,
NRBC,
 polychromatophilia
Direct
Coombs
Test
Positive direct Combs' test.
ANEMIA -Dr.Alagbare

7. ANEMIA -Dr.Alagbare
Mechanism of CAIHA
• Patients make anti-red-cell antibodies which are IgM in nature
And in the cold environment IgM binds to the red cell best at
temperatures <37° C.
IgM with the RBC cause agglutination in the small Capillaries
Leading to cyanosis and ischemia in extremities. (Ear, nose fingers
cold places)
Cold Autoimmune hemolytic anemia (CAIHA)

8. Autoimmune hemolytic anemia - CAIHA
Classification Cold Autoimmune hemolytic anemia (CAIHA)
Antibody Coating
RBC
 IgM and participate the complement
Cause intravascular hemolysis
Temperature 25ºC
Etiology secondary to infection
e.g. mycoplasma, EBV
ANEMIA -Dr.Alagbare

9. Autoimmune hemolytic anemia – CAIHA Diagnosis
CBC result Mild anemia
MCHC> 37 g/dl
Increase reticulocytes ,
Blood Film RBC agglutination
Direct Coombs
Test
positive for complement
ANEMIA -Dr.Alagbare

10. ‫رب‬ ‫هلل‬ ‫الحمد‬
‫العالمين‬
‫ابتغي‬ ‫العمل‬ ‫هذا‬
‫الكريم‬ ‫هللا‬ ‫وجه‬ ‫به‬
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