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Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Hemolytic Anemia (AIHA ... Table Warm AIHA ... Disease Mixed-type AIHA ... DAT-negative AIHA ... Hemolytic #Anemia #AIHA
Autoimmune Hemolytic Anemia (AIHA) Pathophysiology - Warm vs Cold AIHA
Warm AIHA:
 - 70%; IgG mediated
 -
Hemolytic Anemia (AIHA ... - Warm vs Cold AIHA ... Warm AIHA: - 70% ... spherocytes Cold AIHA ... BrighamMedRes #AIHA
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Hemolytic Anemia (AIHA ... Treatment Warm AIHA ... azathioprine Cold AIHA ... BrighamMedRes #AIHA ... Hemolytic #Anemia #AIHA
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Immune-Mediated • Warm AIHA ... • Cold AIHA ... • Drug-induced AIHA ... Complement-Mediated • Cold AIHA
Autoimmune Hemolytic Anemia (AIHA)

WARM AHA
- Primary - Idiopathics
- Secondary
Infectious
 • Viral- HIV, EBV, HCV, HEV
 •
Hemolytic Anemia (AIHA ... ) WARM AHA - ... alpha-methyldopa COLD AHA ... Hemolytic #Anemia #AIHA
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
1) DIAGNOSE AIHA ... screening 3) TREAT AIHA
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Autoimmune: Warm AIHA ... , Cold AIHA, Transfusion
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
- Autoimmune (AIHA ... - Autoimmune (AIHA
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
atheroembolic, AIHA
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
Viral, Ischemia, AIH ... - Viral, AIH ... Alcohol, Viral, HH, AIH