Autoimmune hemolytic anemias Flashcards
Allo-immune
Auto-Immune
Drug induced
allo immune- outside stim
Auto immune- Attacking self
Drug induced - consequence of treatment
Immune anemias cause the destruction of…
rbcs and metabolism of products of destruction
Alloimmune causes
HTR, HDN
Autoimmune causes
c,p,w
CAS, PCH, WAIHA
Drug induced
dependent?
a?
d?
hapten dependent, auto, drug dependent
IgM
messes with?
what binds?
messes w reverse type (at room temp)
ABO binds compliment
Anemia classification
Class, compliment, strength, immune activation, titer….etc
First differentiating factor in autoimmune hem anemias
warm vs cold
Warm anemias overview
temp?
what may bind?
DAT rxn?
A?
extra?
Frequently?
Symptoms?
more in?
> 32 degrees
IgG may bind
DAT: IgG+ C3+/-
AHG
Extravascular
Frequently Rh
exhausted/anemic
more in the summer
Cold anemias overview
temp?
what class?
rxn?
spin?
hemolysis?
frequently?
extremities?
more in?
<30 degrees
IgM binds compliment
IgG - C3+
IS
Intra/extra
Frequently I or P
purple extremities
more in winter
Cold Rxn Antibodies
Benign
common?
low?
enhanced with?
ig class?
Anti?
most common
low titer
enhanced with alb/enzymes
IgM
Anti-I, IH or i
Cold rxn Antibodies
Pathogenic
common?
high?
enhanced with?
class?
Anti?
not common
high titer >1000
enhanced with alb/enzymes
IgM
Anti-I, P or M
Benign cold agglutinins
Anti-I
Anti- i
Anti- IH
Anti- I : doesnt react with cord rbcs
Anti- i: doesnt react w/ adult rbc
Anti-IH: doesnt react w/ AI, B or AB rbcs
Precursors
to developing….
to developing other autooimmune disorders like lupus, titer 0 cells <65
T/F pre-warm IS crossmatch and reverse type
ture
Patho cold agglutinins
CHD
chronic
symptoms?
ages?
AB?
wide range?
titer?
cells?
may have to do?
chronic hem anemia, purple, reynaurds disease
adults
Ab: Anti-I wide range thermal IgM
titer >1000 O cells
may have to do 60 min settling techniques for neg results
PCH
after a virus, transient, children, Donthanlandstiener
IgG
specificity to Anti-P
Warm autoab
extreme? no previous?
prefrerence? ig?
AVOID?
prevents? find a way?
extreme anemia, usally no previous transfusion
Rh preference, IgG may not fix compliment
AVOID TRANSFUSIONS
Prevent ID of allo-ab becausse they react with everything, find a way to remove auto ab to ID the ALLO
Best ways to remove autoab to ID allo ab
AUTOABSORPTION BEST
allo abosroption - ref lab
Saline and cells/molecular
Drug induced ab
looks like?
stop?
very fast?
hemolysis characterized by?
look like warm auto
stop taking drug
very fast hemolysis sometimes death
hemolysis characterized by tea like plasma color
Drug-absorption
drug attaches?
no?
Drugs? (c/s/p)
drug attaches to rbc membrane
ab directed to drug causes destruction of rbc
IgG no compliment
CEFOTETAN
STREPTOMYCIN
PENICILLIAN
Drug absorption detection
DAT
E
Hem?
DAT: IgG + C3-
eluate: neg
Hemolysis: yes
Immune complex
forms ab to?
drugs? q/p
DAT?
Eluate?
Hem location?
forms ab to drug
QUINDINE/PHENACETIN
DAT: IgG +/= C3+
eluate: neg
Hem: yes intra
Membrane modification
non?
Drug?
DAT?
E?
Hemolysis?
non immune process
CEPHALOSPORIN
IgG+ C3+
E: neg
Hem: no
Drug Independent
autoab forms?
Drug? (a)
DAT?
E?
Hem?
autoab forms after 6 mos
ALPHA METHYLADOPA
IgG+ C3+/=
Elut: pos
Hem: yes
Chemo Drug
attaches to?
Drug name? (D)
DAT rxn?
what blood is given to all pts?
Dtt ?
attaches to CD38
DARZALEX-UMAB
weak pos DAT
Big K- blood to all pts
DTT removes ag
Treatment of cold anemias
skip?
blood warmer, skip IS
Treatment of Warm anemias
DONT TRUST?
transfer only?
dont trust sero presentation
transfer only to support cardiovasc funct
Treatment of drug anemias
tras…
p
transfusion reccomended in most cases, plasma exchange
Which DAT result are consistend with CAD
Poly 3+
IgG 0
C3D 3+
