Haemolytic Anaemia: Warm And Cold And Malaria Flashcards
What is warm AIHA?
An IgG-mediated extravascular haemolytic disease, in which the spleen tags cells for splenic phagocytosis.
What is the cause of warm AIHA?
SLE, idiopathic, lymphoproliferative neoplasms (eg. chronic lymphocytic leukaemia and lymphoma), drugs (methyldopa)
How is warm AIHA managed?
Managed with prednisolone or immunosupression (e.g. AZT) and transfusions if severe
What is cold AIHA?
IgM-mediated haemolytic disease, in which IgM fixes complement causing direct intravascular haemolysis. It includes cold agglutinin disease
The IgM agglutinates also cause the hands and feet to become blue in cold conditions (acrocyanosis)
What is the cause of cold AIHA?
post-infectious (usually after Mycoplasma or EBV), idiopathic, lymphoproliferative disorders
What is the management of AIHA?
supportive, warmed blood is transfused if required and resistant cases may trial rituximab
What is the treatment of acute and severe malaria?
Artesenate which inhibits haem polymerisation
How does haemolytic anaemia affect HbA1?
Falsely low Hb A1c due to reduced red cell life span
How is HbA1c affected after a splenectomy?
Falsely high HbA1c as RBC now have a higher lifespan and able to become glycosylated
Which prophylactic antibiotic should be given after splenectomy?
Phenoxymethylpenicilin
Which condition requires splenectomy at a young age in childhood?
Hereditary spherocytosis
