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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) - ... Cold Agglutinin Disease ... #Anemia #AIHA # ... #Table #hematology
Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... - Differential ... Anemias (AIHAs) ... Hypersplenism, Infection ... #Anemias #Differential
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... - Autoimmune (AIHA ... - Autoimmune (AIHA ... Extravascular #Causes #differential ... #anemia
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
- Differential ... circulation - Infections ... anemia • ... Extravascular #Differential ... Algorithm #Causes #Hematology
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Anemia (AIHA) Treatment ... esp if severe disease ... Polyclonal: - Infection ... #Anemia #AIHA # ... Treatment #management #hematology
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... Autoimmune: Warm AIHA ... Internal (RBC) - Infections ... Defects: Sickle cell anemia ... Diagnosis #hematology
Differential Diagnosis for Hemolytic Anemia
Intrinsic Causes:
 • Enzyme deficiencies ex. G6PD, pyruvate kinase 
 • Hemoglobinopathies
for Hemolytic Anemia ... Causes: • Liver disease ... Hypersplenism • AIHA ... drug induced • Infections ... #Anemia #Differential
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... - Differential ... inclusions - If infection ... #Anemia #Differential ... Algorithm #workup #hematology
Cold Agglutinin Disease

3 Types of Cold Sensitive Antibodies:
  1. Cold Agglutinins (CAD)
  2. Donath-Landsteiner
women • 15% of AIHA ... anemia • Cold ... younger pts) Differential ... #hemolytic #anemia ... #hematology #diagnosis
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

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