Anemia, Autoimmune Hemolytic

Rahul Banerjee, MD and Heather J. Hue, MD, MPH Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Autoimmune hemolytic anemia (AIHA): premature or accelerated destruction of RBCs in the presence of anti-RBC autoantibodies (1,2)

  • Classified into three main groups (1,2)

    • Warm AIHA (a...

DIAGNOSIS

HISTORY

  • Symptoms of anemia: fatigue/weakness, palpitations, dyspnea, dizziness (1,2)[C]

  • Symptoms of hemolysis: jaundice (± dark urine in intravascular hemolysis, e.g., PCH) (1,2)[C]

  • Temperature...

TREATMENT

GENERAL MEASURES

  • Treatment of underlying condition if identified (1,2)[C]

  • Avoidance or discontinuation of triggering agents (cold weather or fluids for cold AIHA, offending medication for drug...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

MONITORING

  • Serial hemoglobin measurements to evaluate degree of anemia and/or ongoing hemolysis (2,6)[C]

  • Avoidance of hypothermic fluids, blood products, or surgerie...

REFERENCES

Barcellini W. Immune hemolysis: diagnosis and treatment recommendations. Sem Hematol.  2015;52(4):304–312. [View Abstract on OvidInsights]
Bass GF, Tuscano ET, Tuscano JM. Diagnosis a...

ADDITIONAL READING

  • Berentsen S, Sundic T. Red blood cell destruction in autoimmune hemolytic anemia: role of complement and potential new targets for therapy. Biomed Res Int.  2015;2015:363728. [...

SEE ALSO

  • Chronic Lymphocytic Leukemia (CLL); Non-Hodgkin Lymphomas (NHL); Lupus Erythematosus, Systemic (SLE)

  • Algorithm: Anemia

CODES

ICD10

  • D59.1 Other autoimmune hemolytic anemias

  • D59.0 Drug-induced autoimmune hemolytic anemia

ICD9

283.0 Autoimmune hemolytic anemias 

SNOMED

  • 413603009 Autoimmune hemolytic anemia (disorder)

  • 309742004 ...

PEARLS

  • AIHA is a rare cause of hemolytic anemia, generally diagnosed with a positive DAT assay (Coomb).

  • DAT-negative AIHA (2–10% of all AIHA cases) is a diagnostic challenge.

  • In AIHA secondary to an und...

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