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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) - ... Agglutinin Disease ... MatthewHoMD #Autoimmune ... #Hemolytic #Anemia
Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
of anemia and hemolysis ... Immune-mediated Hemolysis ... : • Autoimmune ... (AIHAs) • Alloimmune ... Nonimmune-mediated Hemolysis
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Framework for Hemolysis ... Intravascular Hemolysis ... Extravascular Hemolysis ... (AIHA)"Cold" (usually ... EricsMedicalLectures/ #Hemolysis
Autoimmune Hemolytic Anemia (AIHA) Pathophysiology - Warm vs Cold AIHA
Warm AIHA:
 - 70%; IgG mediated
 -
Autoimmune Hemolytic ... Anemia (AIHA) Pathophysiology ... - Warm vs Cold ... #Autoimmune #Hemolytic ... #Anemia #Pathophysiology
Cold Agglutinin Disease

3 Types of Cold Sensitive Antibodies:
  1. Cold Agglutinins (CAD)
  2. Donath-Landsteiner
Cold Agglutinin ... anemiaCold ... • Compensated hemolysis ... intravascular hemolysis ... #hemolytic #anemia
Expected DAT Results in Autoimmune Hemolysis
DAT Negative Hemolysis
 • DAT Poly ( - ), IgG (
Hemolysis DAT ... Negative Hemolysis ... ), C3d ( - ) WAIHA ... agglutinin disease ... #Hemolysis #hematology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Intravascular Hemolysis ... and RES-mediated hemolysis ... • Cold AIHA ... Intravascular - Hemolysis ... malformations #Hemolysis
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Autoimmune Hemolytic ... Anemia (AIHA) Treatment ... > 10, no more hemolysis ... #Autoimmune #Hemolytic ... #Anemia #AIHA #
Hemolysis - Differential Diagnosis Framework

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