Warm antibody autoimmune hemolytic anemia

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Warm antibody autoimmune hemolytic anemia
Other namesWAIHA
SpecialtyHematology Edit this on Wikidata

Warm antibody autoimmune hemolytic anemia (WAIHA) is the most common form of

autoimmune haemolytic anemia.[1] About half of the cases are of unknown cause, with the other half attributable to a predisposing condition or medications being taken. Contrary to cold autoimmune hemolytic anemia (e.g., cold agglutinin disease and paroxysmal cold hemoglobinuria) which happens in cold temperature (28–31 °C), WAIHA happens at body temperature.[citation needed
]

Causes

AIHA may be:

Medications

Pathophysiology

The most common

spherocytes. Spherocytes are not as flexible as normal RBCs and will be singled-out for destruction in the red pulp of the spleen as well as other portions of the reticuloendothelial system. The red blood cells trapped in the spleen cause the spleen to enlarge, leading to the splenomegaly often seen in these patients.[citation needed
]

There are two models for this: the

cephalosporins, will bind to certain proteins on the red cell membrane and act as haptens (small molecules that can elicit an immune response only when attached to a large carrier such as a protein; the carrier may be one that also does not elicit an immune response by itself). Antibodies are created against the protein-drug complex, leading to the destructive sequence described above. The autoantibody model proposes that, through a mechanism not yet understood, certain drugs will cause antibodies to be made against red blood cells which again leads to the same destructive sequence.[citation needed
] It is possible for it to occur in an immunocompromised patient.[3]

Diagnosis

Diagnosis is made by a positive direct Coombs test, other lab tests, and clinical examination and history. The direct Coombs test looks for antibodies attached to the surface of red blood cells.[citation needed]

Clinical findings

Laboratory findings include severe

hyperbilirubinemia (from increased red cell destruction) that can be of the conjugated or unconjugated type.[citation needed
]

Treatment

Corticosteroids and immunoglobulins are two commonly used treatments for warm antibody AIHA. Initial medical treatment consists of prednisone. If ineffective, splenectomy should be considered.[citation needed
]

If refractory to both these therapies, other options include

cyclosphosphamide, azathioprine, or ciclosporin. High-dose intravenous immune globulin may be effective in controlling hemolysis, but the benefit is short lived (1–4 weeks), and the therapy is very expensive.[citation needed
]

See also

References

  1. .
  2. ^ a b AUTOIMMUNE HEMOLYTIC ANEMIA (AIHA) Archived 2009-10-07 at the Wayback Machine By J.L. Jenkins. The Regional Cancer Center. 2001
  3. PMID 11846306
    .
  4. .
  5. .

External links