Anemia with High Reticulocytes: Acquired Hemolytic D/Os

Question 1

Warm Antibody Autoimmune Hemolytic Anemia
Positive for what?
Hemolysis happening where?
Clinical features of anemia which may be acute include?

Answer 1

Direct Coombs for IgG+/-C3
Extravascular in spleen
Fatigue, DOE

Question 2

Warm Antibody Autoimmune Hemolytic Anemia
Approach to treatment

Answer 2

Treat any underlying illness
Prednisone (1mg/kg/d for 2wk then taper)
Splenectomy

Question 3

Cold Agglutinin Disease (CAD)
what antibodies? that fix what?
Direct coombs is what?

Answer 3

IgM; complement
Positive for anti-C3

Question 4

Cold Agglutinin Disease (CAD)
Acute CAD
Antibodies d/t what?
Peaks when?

Answer 4

infection (EBC and Mycoplasma)
2-3 wks after iinfection

Question 5

Cold Agglutinin Disease (CAD)
Chronic CAD
Monoclonal Antibodies associated with what?

Answer 5

CLL
Lymphoma
Waldenstrom’s disease (~50% of cases)

Question 6

Cold Agglutinin Disease (CAD)
Clinical features

Treatment depends on

Answer 6

Hemolysis and anemia (jaundice; fatigue)
Cold exposure; acrocyanosis

underlying cause