The classification of aiha is based on the immunochemical properties of the rbc autoantibody. Aiha caused by warm autoantibodies waiha, ie, antibodies that react with their antigens on the red blood cell optimally at 37c, is the most common type, comprising. Aiha caused by warmreacting antibodies is the most common form, and half of these are idiopathic. For this reason, they are called warm agglutinins even though they seldom directly agglutinate the rbcs. Autoimmune hemolytic anemia, or aiha, is an immune condition where the immune system destroys red blood cells. The terminology applied to autoimmune hemolytic anemia aiha seems inconsistent. Shown are the spectrum of dat serologic findings, autoimmune hemolytic classifications, antigen specificity, and medicaldrug associations.
Cardiac operation for a patient with autoimmune hemolytic. Milder agglutination sometimes occurs in warm aiha and. How i treat autoimmune hemolytic anemia american society of. Autoimmune hemolytic anemia aiha is a relatively uncommon disorder, characterized by autoreactive antibodies directed against endogenous red blood cell antigens. Autoimmune diseases occur when the bodys natural defenses against foreign organisms e. Excluding secondary causes of aiha is the first step in treatment decisionmaking. How would you further evaluate and treat this patient.
Autoimmune hemolytic anemia aha is a group of disorders where your immune system mistakenly destroys your own red blood cells rbcs. Attempts to categorise autoimmune haemolytic anaemia. How i treat autoimmune hemolytic anemia blood american. Warm autoimmune hemolytic anemia aiha is a rare disease, occurring in both idiopathic and secondary forms. Autoimmune hemolytic anemia aiha is a rare autoimmune disease in which autoantibodies target red blood cells leading to marked decrease in their lifespan. Warm autoimmune hemolytic anemia hematologyoncology clinics. Autoimmune hemolytic anemia aiha due to the presence of warm agglutinins is almost always due to immunoglobulin g igg antibodies that react with protein antigens on the red blood cell rbc surface at body temperature.
Autoimmune hemolytic anemia, hemolysis, coldautoantibodies, warm. Warm antibody aiha waiha accounts for 7580% of all adult aiha cases. Warm antibody hemolytic anemia is an autoimmune disorder characterized by the premature destruction of healthy red blood cells by autoantibodies. Warm autoimmune hemolytic anemia waha leads to accel erated. Warm autoimmune hemolytic anemia is a chronic, relapsing disease characterized by anemia, reticulocytosis, other evidence of hemolysis, and a positive direct antiglobulin test. These rare conditions occur when antibodies proteins. After identifying hemolytic anemia with a positive dat, hopefully obvious causes, such as a delayed transfusion reaction from a recent transfusion, alloimmune hemolysis following solid organ or allogeneic stem cell transplantation, druginduced immune hemolysis, or hemolytic disease of the newborn, will be quickly identified by clinical assessment. Moreover, a brief overview on the treatment of different forms of aiha is given. Autoimmune hemolytic anemia aiha with warmreactive antibodies is a rare type of acquired hemolytic anemia caused by an antibody reaction against a patients own erythrocytes at normal body temperature. Autoimmune hemolytic anemia aiha is a rare and heterogeneous disease that affects 1 to 3100 000 patients per year. Patients with warm autoimmune hemolytic anemia may present with jaundice, fatigue, and anemia, or they may show no overt clinical manifestations.
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