AUTOIMMUNE

HEMOLYTIC ANEMIA

Reported by: Kathleen Chris G.

Lapac MLS 3-A
AUTOIMMUNE HEMOLYTIC ANEMIA (AHA)
It is a rare disorder characterized by premature
RBC destruction and anemia caused by
autoantibodies that bind the RBC surface with or
without complement activation. (Etiology or
Cause)
Autoantibodies may arise as a result of immune
system dysregulation and loss of immune
tolerance, exposure to antigen similar to
autoantigen, B lymphocyte neoplasm and others.
 Characteristics of AHA
Warm AHA Cold Paroxysma Mixed
Agglutinin l Cold Type AHA
Dse Hemoglobi
nria
Ig class IgG (rarely IgM IgG IgG, IgM
IgM, IgA)
Optimum 37C 4C, 4C 4-37 C
reactivity reactivity
temperature extends to >
of 30 C
autoantibod
y
Sensitizatio IgG or IgG + C3d C3d IgG and C3d
n detected C3d, only
by direct C3d
antiglobin uncommon
test
 Warm AHA Cold Paroxysma Mixed
Agglutinin l Cold Type AHA
Dse Hemoglobi
nria

Complement Variable Yes Yes Yes

Activation
Hemolysis Extravascul Extravascul Intravascula Extravascul
ar primarily ar, rarely r ar and
intravascula Intravascula
r r
Autoantibod Panreactive I (most), i P Panreactive,
y specificity or Rh (some), Pr unclear
complex;rare (rare) specificity
ly specific
Rh or other
antigen
WARM AUTOIMMUNE HEMOLYTIC
ANEMIA
 Warm Autoimmune Hemolytic Anemia
-most commonly found in adults older than 40
years of age and in children younger than 4
years of age

Classification

Idiopathic- etiology is unknown

Secondary- found in conditions such as
lymphoproliferative diseases, nonlymphoid
neoplasms, autoimmune disorders,
immunodeficiency disorders, viral infections
COLD AGGLUTININ DISEASE
 Cold Agglutinin Disease

Chronic CAD-occurs in middle-aged and

elderly individuals

Acute CAD-occurs secondary to

Mycoplasma pneumoniae infection,
infectious mononucleosis and other viral
infections
PAROXYSMAL COLD HEMOGLOBINURIA
 Paroxysmal Cold Hemoglobinuria

-commonly seen in young children after a

respiratory infection
-rare in adults
-anti-P autoantibody also called as Donath-
Landsteiner antibody is a complement-
binding IgG hemolysin with specificity for
the P antigen on RBCs
 Mixed-Type AHA
-occurs very infrequently

Source: Hematology (Clinical Principles and

Application) by Rodak