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Autoimmune Hemolytic Anemia, Pediatric

Kandace L. Gollomp, MD and Michele Puszkarczuk Lambert, MD, MSTR Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Autoimmune hemolytic anemia (AIHA) is characterized by shortened red cell survival caused by autoantibodies directed against RBC surface antigens, with or without the participation o...

DIAGNOSIS

HISTORY

  • Pallor

  • Jaundice

  • Dark urine

  • Fever

  • Weakness

  • Dizziness

  • Syncope

  • Exercise intolerance

PHYSICAL EXAM

  • Pallor

  • Jaundice

  • Splenomegaly

  • Hepatomegaly

  • Tachycardia, systolic flow murmur, S3 gallop

  • Orthostasis in ...

TREATMENT

MEDICATION

First Line

  • Corticosteroids

    • Indication:

      • In IgG-mediated disease, steroids have been shown to interfere with macrophage Fc and C3b receptors responsible for RBC destruction. In addition...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Hemoglobin level q4h–q12h (depending on severity) until stable

  • Reticulocyte count: daily

  • Spleen size: daily

  • Hemoglobinuria: daily

  • Coombs: weekly

PROGNOSIS

ADDITIONAL READING

  • Barros MMO, Blajchman MA, Bordin JO. Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and treatment. Transfus Med Rev.  2010;24(3):195–210. ...

CODES

ICD9

  • 283.0 Autoimmune hemolytic anemias

ICD10

  • D59.1 Other autoimmune hemolytic anemias

  • D59.0 Drug-induced autoimmune hemolytic anemia

SNOMED

  • 413603009 Autoimmune hemolytic anemia (disorder)

  • 309742004 D...

FAQ

  • Q: Will the anemia go away?

  • A: Children with cold autoantibodies tend to have short-lived illness, whereas children with warm antibodies often have a chronic clinical course characterized by period...

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