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Blood Bank Module 3 > Auto Immune Hemolytic Anemia > Flashcards

Auto Immune Hemolytic Anemia Flashcards

1
Q

What is the autoantibody production theory?

A

Autoantibody production is usually prevented by feedback mechanism. Suppressor T-Cells induce tolerance to “self” antigens by inhibiting B-cell activity. If T-supressor cells lose function ten autoantibody production results

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2
Q

What is the diagnostic test for autoimmune hemolytic anemia?

A

Positive DAT (pos autocontrol and Rh control also)

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3
Q

Appearance of positive DATs for autoantibodies due to transfusion reactions

A

*

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4
Q

Appearance of positive DATs for alloantibodies due to transfusion reactions

A

Recipient antibody attaches to transfused donor cells with corresponding

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5
Q

Appearance of alloantibodies due to HDFN

A

Mother’s IgG antibody crosses the placenta and attaches to the baby’s paternally derived antigens

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6
Q

Autoanti-I

- who makes the autoantibodies

A

Everyone?

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7
Q

Autoanti-I

- Expected test reactions with Adult vs Cord Cells

A

Reacts with adult cells

non reactive with Cord cells

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8
Q

Autoanti-H

- Who makes the autoantibodies

A

Seen in group A1 and A1B patients, whose cells have most of the “H” antigen covered up

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9
Q

Autoanti-H

- Expected test reactions with A1 vs O cell

A

Strongly reactive with group O cells and non-reactive with A1 or A1B

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10
Q

CHD

- Cause

A

Caused by anti-I (very high titers and greater thermal amplitude)

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11
Q

CHD

- Symptoms

A
  • Acrocyanosis
  • Numbness in extremities
  • Raynaud’s syndrome
  • hemoglobinurea (in some)
  • auto agglutination of blood at RT
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12
Q

CHD

- Lab results

A
  • hemoglobinurea (in some)

- high titer anti-I at 4C

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13
Q

CHD

- Reactivity Temperature

A

Cold! 4C

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14
Q

CHD

- Treatment

A

Keep warm/avoid the cold

- if needs transfusion, transfuse blood through blood warmer

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15
Q

CHD

- DAT

A

complement only

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16
Q

CHD

- D-L test result (pos/neg)

A

Negative

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17
Q

CHD

A

*

18
Q

CHD

A

*

19
Q

CHD

A

*

20
Q

PCH

- What does it stand for?

A

Paroxysmal Cold Hemoglobinurea

21
Q

PCH

- Antibody specificity

A

IgG antibody (Anti-P; Biphasic autohemolysin) binds to patients cells at low temps, fixes complement, which leads to intravascular hemolysis of cells at 37C

22
Q

PCH

- Diagnostic test and what is the result?

A

Donath-Landsteiner Test

- Positive

23
Q

PCH

- symptoms

A

symptoms often follow viral illnesses such as measles, chicken pox, flu, infectious mono

  • fever
  • shaking chills
  • malaise
  • abdominal cramps
  • back pain
24
Q

PCH

- Lab findings

A
  • hemoglobinurea

- hemoglobinemia

25
Q

PCH

- Treatment

A

Avoid cold exposure

- supportive treatment

26
Q

PCH

- DAT

A

Complement only

27
Q

WAIHA

- what does it stand for

A

Warm Auto Immune Hemolytic Anemia

28
Q

WAIHA

- What temperature does it react

A

37C

29
Q

WAIHA

- DAT

A

positive coated with IgG (some may also have complement coating cells

30
Q

WAIHA

- majority of patients will have _____ and need _____

A

anemia; transfusions

31
Q

WAIHA

- Symptoms

A

pallor, weakness, dizziness, dyspnea, jaundice, unexplained fever

32
Q

WAIHA

- onset is usually _______

A

chronic

33
Q

WAIHA

- DAT

A

positive (IgG OR IgG and complement)

34
Q

WAIHA

- Treatment

A

Patient cells can’t be AHG-antigen typed by routine methods - must treat patient cells with EGA or Chloroquine diphosphate (CDP) to remove the AB coating cells

35
Q

WAIHA

- Eluate Reactivity

A

panreactive

36
Q

WAIHA

- The MOST important part of a work up is what?

A

is to identify any underlying alloantibodies

- adsorption procedures often needed

37
Q

WAIHA

- treatment

A
  • cortosteroids
  • splenectomy
  • Immunosuppressive drugs
  • transfusion as a last resort
38
Q

WAIHA

- IAT

A

may be positive or negative

- id positive adsorption must be performed to look for underlying alloantibodies

39
Q

Drug-Induced Autoimmune Hemolytic Anemia

- DAT

A

positive

40
Q

Drug-Induced Autoimmune Hemolytic Anemia

- treatment

A

discontinue drug

41
Q

Drug-Induced Autoimmune Hemolytic Anemia

-

A

*

42
Q

Drug-Induced Autoimmune Hemolytic Anemia

A

*

Blood Bank Module 3 (10 decks)

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