Monday, 1 November 2010

MRCP revision battle 39.7: Autoimmune haemolytic anaemia

Autoimmune haemolytic anaemia (AIHA) is mediated by autoantibodies and results in mainly extravascular haemolysis.

AIHA will result in a positive direct antiglobulin test (= positive Coombs test)

AIHA is divided depending on the optimal binding temperatures of the autoantibodies to the RBCs.

Warm AIHA = 37C
  • Ig G
  • SLE, lymphoma, CLL, methyl dopa
  • treatment: steroids, immunosupression, splenectomy

Cold AIHA = 4C 
  • IgM
  • lymphoma, mycoplasma, EBV
  • treatment: keep warm, ?chlorambucil