Anaemia - Haemolytic Anaemia - Autoimmune Haemolytic Anaemia (AIHA) Flashcards

1
Q

What is AIHA?

A

Autoimmune Haemolytic Anaemia - antibodies are created against the patient’s RBCs, leading to their destruction.

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2
Q

What are the types of AIHA? (2).

A

Based on the temperature of the functioning of autoantibodies :-

  1. Warm-Type AIHA (commoner).
  2. Cold-Type AIHA.
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3
Q

What is Warm-Type AIHA?

A

Extravascular (splenic) haemolysis occurs at normal or above normal temperatures by IgG antibodies.

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4
Q

Aetiology of Warm-Type AIHA.

A
  1. Idiopathic usually.
  2. Autoimmune Disease e.g. SLE.
  3. Neoplasia e.g. Lymphoma, CLL.
  4. Drugs e.g. Methyldopa.
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5
Q

What is Cold-Type AIHA?

A

Cold-Agglutinin Disease - agglutination (and consequent destruction) at lower temperatures; intravascular haemolysis mediated by Complement and IgM.

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6
Q

Aetiology of Cold-Type AIHA (4).

A

Secondary to Other Conditions e.g. :

  1. Lymphoma.
  2. Leukaemia.
  3. SLE.
  4. Infections e.g. Mycoplasma, EBV, CMV, HIV.
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7
Q

Clinical Presentation of Cold-Type AIHA (2).

A
  1. Raynaud’s.

2. Acrocyanosis.

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8
Q

Investigations of AIHA (3).

A
  1. Bloods : Anaemia, Reticulocytosis, Low Haptoglobin, Raised LDH and Indirect Bilirubin.
  2. Blood Film : Spherocytes and Reticulocytes.
  3. Positive Coombs’ (Direct Antiglobulin) Test.
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9
Q

What is Coombs Test?

A

Antibodies are used against the autoantibodies to test for their presence.

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10
Q

Management of AIHA.

A
  1. Blood Transfusions.
  2. Prednisolone (Steroids).
  3. Rituximab (Monoclonal Antibody against B cells).
  4. Splenectomy.
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