Quesmed videos (haemolytic anaemia 5) Flashcards

1
Q

What is warm autoimmune haemolytic anaemia?

A

The most common form of autoimmune haemolytic anaemia (AIHA).

The “warm” in its name refers to the autoantibodies generated by the body, which are active only at body temperatures

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2
Q

Cold autoimmune haemolytic anaemia is more common than warm autoimmune haemolytic anaemia. True/false?

A

False

Warm autoimmune haemolytic anaemia is more common than cold.

Accounts for 80-90% of cases.

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3
Q

What is the underlying pathology of warm autoimmune haemolytic anaemia?

A

In warm autoimmune haemolytic anaemia, the IgG antibodies bind to antigens on the RBC membrane, this triggers the macrophages to antibodies and cause RBC haemolysis.

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4
Q

What blood test features indicate haemolytic anaemia?

A

Normocytic anaemia

Raised LDH

Raised unconjugated bilirubin

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5
Q

What immunoglobulin mediates warm autoimmune haemolytic anaemia and what type of process is warm autoimmune haemolytic anaemia?

A

IgG mediated - extravascular splenic phagocytosis

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6
Q

What temperature does warm autoimmune haemolytic anaemia usually occur?

A

> /=37 degrees celsius which is typical internal body temperature

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7
Q

Causes of warm autoimmune haemolytic anaemia?

A

Idiopathic

Lymphoproliferative malignancies i.e. CLL, lymphoma

Inflammatory conditions i.e. SLE

Infection i.e. HIV, EBV

Medications: methyldopa, penicillin, cephalosporin.

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8
Q

How is warm autoimmune haemolytic anaemia diagnosed?

A

Direct coombes test will show a positive result.

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9
Q

Apart from a positive direct Coombes test, what else would be shown for warm autoimmune haemolytic anaemia?

A

Severe normocytic anaemia

Raised bilirubin

Raised LDH

Raised reticulocytes

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10
Q

What is the treatment for warm autoimmune haemolytic anaemia?

A

Hb < 70g/l - transfusion

Steroids i.e. prednisolone (first line)

Immunosuppressants i..e monoclonal antibodies, azathioprine

Refractory cases - splenectomy

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11
Q

What type of autoimmune haemolytic anaemia is plasmapheresis typically used for?

A

Cold autoimmune haemolytic anaemia

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12
Q

What is ferrous fumarate typically used for?

A

Iron-deficiency anaemia

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13
Q

What is hydroxocobalamin used for?

A

Anaemia that occurs due to vitamin B12 deficiency.

This would usually show high MCV RBC’s on blood film.

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14
Q

What is first line for warm autoimmune haemolytic anaemia?

A

Prednisolone

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15
Q

What is the primary cause of both warm and cold autoimmune haemolytic anaemia?

A

Idiopathic

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16
Q

What are the secondary causes of both warm and cold autoimmune haemolytic anaemia?

A

Warm
- Drugs
- Lymphoma
- SLE

Cold
- Infections i.e. mycoplasma pneumoniae and EBV