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Anemia, Autoimmune Hemolytic

David Nanlin Liu, MD and Laura B. Bishop, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Autoimmune hemolytic anemia (AIHA): Premature destruction of red blood cells (RBCs) mediated by autoantibodies against RBC surface antigens (1,2)

  • Classified into three main groups (...

DIAGNOSIS

HISTORY

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

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

  • Temperature-rel...

TREATMENT

GENERAL MEASURES

  • Treatment of underlying condition or medication if identified (1,2)

  • Avoidance of triggering agent (1)[C]

    • Cold weather, cold intravenous (IV) fluids for cold AIHA

  • Vitamin suppl...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Serial Hgb measurements to evaluate degree of anemia and/or ongoing hemolysis (1,2)

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

REFERENCES

1
Go  RS, Winters  JL, Kay  NE. How I treat autoimmune hemolytic anemia. Blood.  2017;129(22):2971–2979. [View Abstract on OvidMedline]
2
...

ADDITIONAL READING

  • Khan  U, Ali  F, Khurram  MS, et al. Immunotherapy-associated autoimmune hemolytic anemia. J Immunother Cancer.  2017;5:15. [View Abstract on OvidMed...

SEE ALSO

  • Algorithm: Anemia

CODES

ICD10

  • D59.1 Other autoimmune hemolytic anemias

  • D59.0 Drug-induced autoimmune hemolytic anemia

SNOMED

  • 413603009 Autoimmune hemolytic anemia (disorder)

  • 309742004 Drug-induced autoimmune hemolytic anemi...

CLINICAL PEARLS

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

  • For primary warm AIHA, corticosteroids are the first-line treatment; alternatives include rituxim...

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