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Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Anemia (AIHA) - ... MatthewHoMD #Autoimmune ... #Hemolytic #Anemia ... Diagnosis #Table #hematology
Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... : • Autoimmune ... Hemolytic Anemias ... (AIHAs) • Alloimmune ... Hemolytic Anemias
Autoimmune Hemolytic Anemia (AIHA)

WARM AHA
- Primary - Idiopathics
- Secondary
Infectious
 • Viral- HIV, EBV, HCV, HEV
 •
Autoimmune Hemolytic ... Anemia (AIHA) ... alpha-methyldopa COLD ... #Hemolytic #Anemia ... #Differential #Algorithm
Autoimmune Hemolytic Anemia (AIHA) Pathophysiology - Warm vs Cold AIHA
Warm AIHA:
 - 70%; IgG mediated
 -
Autoimmune Hemolytic ... Anemia (AIHA) Pathophysiology ... - Warm vs Cold ... #Autoimmune #Hemolytic ... #diagnosis #hematology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Differential Diagnosis Algorithm ... • Cold AIHA ... • Alloimmune ... anemia • ... #Causes #Hematology
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Autoimmune Hemolytic ... Anemia (AIHA) Treatment ... azathioprine Cold ... #Autoimmune #Hemolytic ... #Anemia #AIHA #
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... (AIHA) "Warm" ( ... (AIHA)"Cold" (usually ... (e.g. primary cold ... #anemia
Cold Agglutinin Disease

3 Types of Cold Sensitive Antibodies:
  1. Cold Agglutinins (CAD)
  2. Donath-Landsteiner
women • 15% of AIHA ... Primary Secondary ... Viral infection, autoimmune ... anemiaCold ... #anemia #hematology
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... Membrane): - Autoimmune ... : Warm AIHA, Cold ... AIHA, Transfusion ... Defects: Sickle cell anemia
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... Differential Diagnosis Algorithm ... Agglutination - Cold ... elliptocytosis, autoimmune ... #workup #hematology