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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 ... hemoglobinuria) • Cold Agglutinin ... Disease Mixed-type ... #Hemolytic #Anemia ... Diagnosis #Table #hematology
Cold Agglutinin Disease

3 Types of Cold Sensitive Antibodies:
  1. Cold Agglutinins (CAD)
  2. Donath-Landsteiner
Viral infection, autoimmune ... CLL (older) • Autoimmune ... pts) Differential ... #disease #hemolytic ... #anemia #hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... . primary cold agglutin ... Extravascular #Causes #differential ... #diagnosis #hematology ... #anemia
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Hemolytic Anemia ... • Blood smear: Differential ... #Hemolytic #Anemia ... diagnosis #management #treatment ... #rheumatology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
- Differential ... Cold AIHA • PCH ... anemia • ... Prosthetic heart valves ... Algorithm #Causes #Hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... Agglutination - Cold agglutinins ... elliptocytosis, autoimmune ... #Anemia #Differential ... Algorithm #workup #hematology
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Autoimmune Hemolytic ... Anemia (AIHA) Treatment ... esp if severe disease ... #Hemolytic #Anemia ... #management #hematology
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... HELLP - Grafts, Valves ... Membrane): - Autoimmune ... Defects: Sickle cell anemia ... Diagnosis #hematology
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
spherocytosis, Autoimmune ... hemolytic anemia ... hemolytic anemia ... RBC #Morphology #differential ... #diagnosis #hematology
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
- Differential ... , CKD • Hemolytic ... - Extrinsic: Autoimmune ... Non-megaloblastic: Liver disease ... #Diagnosis #hematology