anemia

Question 1

What is the site of hemolysis for each AIHA?

Answer 1

Warm AIHA: Extravascular
Paroxysmal Cold Hemoglobinuria: Intravascular
Cold Agglutinin Disease: Extra- and intravascular

Question 2

What are the antigen targets in different types of AIHA?

Answer 2

Warm AIHA: Rh
Paroxysmal Cold Hemoglobinuria: P
Cold Agglutinin Disease:Mycoplasma (Big I)
Epstein-Barr virus (Little i)

Question 3

What are the DAT (Coombs) test findings for each AIHA?

Answer 3

Warm AIHA: IgG+ / C3+
Paroxysmal Cold Hemoglobinuria: IgG+ (cold) / C3+ (warm)
Cold Agglutinin Disease: C3+

Question 4

What are the second-line therapies for each AIHA?

Answer 4

Warm AIHA: Splenectomy, Rituximab
Paroxysmal Cold Hemoglobinuria: Steroids
Cold Agglutinin Disease: Rituximab

Question 5

What is the complement fixing status for each AIHA?

Answer 5

Warm AIHA: Sometimes
Paroxysmal Cold Hemoglobinuria: Yes
Cold Agglutinin Disease: Yes

Question 6

What are the most common causes of HDN?

Answer 6

RhD incompatibility and ABO incompatibility. Other minor blood groups involved include Kell, Duffy, MNS, P, and Diego.

Question 7

Why is HDN due to Kell antigen more severe?

Answer 7

The Kell antigen is expressed on early RBC precursors, leading to reticulocytopenia and severe anemia without hyperbilirubinemia.

Question 8

When should non-pregnant women or men receive RhD immune globulin prophylaxis?

Answer 8

As soon as possible, up to 28 days after exposure to small amounts of RhD-positive blood.

Question 9

How is RhD immune globulin administered based on blood volume exposure?

Answer 9

Intramuscular (IM): Small blood volume exposure
Intravenous (IV): Large blood volume exposure

Question 10

What factors determine whether male patients should receive RhD immune globulin prophylaxis?

Answer 10

If future transfusions are likely to be required.