Autoimmune hemolytic anemia: Difference between revisions
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*Positive direct [[Coombs test]] | *Positive direct [[Coombs test]] | ||
*[[Anaemia]] | *[[Anaemia]] | ||
==Treatment== | |||
Much literature exists regarding the treatment of AIHA. Efficacy of treatment depends on the correct diagnosis of either warm or cold type AIHA. | |||
Warm type AIHA is usually a more insidious disease, not treatable by simply removing the underlying cause. First line therapy for this is usually with [[corticosteroid|corticosteroids]], such as [[prednisolone]]. Following this, other immunosuppressants are considered, such as [[rituximab]], [[danazol]], [[cyclophosphamide]], [[azathioprine]] or [[cyclosporine]]. | |||
Cold agglutinin disease is treated by avoiding the cold or sometimes with rituximab. Removal of the underlying cause is also important. | |||
Paroxysmal cold hematuria is treated by removing the underlying cause, such as infection. | |||
==Related chapters== | ==Related chapters== | ||
Revision as of 19:02, 25 July 2012
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| Autoimmune hemolytic anemia | |
| ICD-10 | D59.0-D59.1 |
|---|---|
| ICD-9 | 283.0 |
| MedlinePlus | 000579 |
| MeSH | D000744 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Autoimmune hemolytic anemia (AIHA) is a type of hemolytic anemia where the body's immune system attacks its own red blood cells (RBCs), leading to their destruction (hemolysis). Antibodies and associated complement system components become fixed onto the RBC surface. These antibodies can be detected with the direct antiglobulin test, also known as the direct Coombs test. AIHA can also be induced by several drugs including methyl-dopa and fluarabine.
Autoimmunity must not be confused with alloimmunity.
Classification
Haemolysis can be intravascular or extravascular.
Intravascular haemolysis
Red blood cell lysis occurs in the circulation as a result of activation of the complement system cascade.
Extravascular haemolysis
Red Blood Cells that are coated with antibodies are specifically recognised in the reticuloendothelial system and destroyed by macrophages.
Subtypes
- Idiopathic
- Systemic lupus erythematosus
- Evans' syndrome (antiplatelet antibodies and haemolytic antibodies)
- Chronic lymphocytic leukemia
- Drugs (methyldopa)
- Cold antibody autoimmune hemolytic anemia
- Mixed-type autoimmune hemolytic anemia
Laboratory findings
- Positive direct Coombs test
- Anaemia
Treatment
Much literature exists regarding the treatment of AIHA. Efficacy of treatment depends on the correct diagnosis of either warm or cold type AIHA.
Warm type AIHA is usually a more insidious disease, not treatable by simply removing the underlying cause. First line therapy for this is usually with corticosteroids, such as prednisolone. Following this, other immunosuppressants are considered, such as rituximab, danazol, cyclophosphamide, azathioprine or cyclosporine.
Cold agglutinin disease is treated by avoiding the cold or sometimes with rituximab. Removal of the underlying cause is also important.
Paroxysmal cold hematuria is treated by removing the underlying cause, such as infection.
Related chapters
Template:Hematology Template:SIB