Abstract

Objectives: Autoimmune hemolytic anemia (AIHA)- an immunological diseaseresulting from red cell hemolysis caused by circulating autoantibodies against antigens on redcell membrane. Positive direct antiglobulin test (DAT) always exist in association with AIHAand form basis for its serologic diagnosis. The objective of our study was to determine clinicalpresentation and etiological pattern in autoimmune hemolytic anemia at a tertiary care hospital.Study Design: Descriptive, cross-sectional study. Setting: Medical unit I of Liaquat UniversityHospital Jamshoro / Hyderabad. Period: 1st January 2010 to 30th June 2010. Patients andMethods: We enrolled 125 patients of either sex and ages from 13 to 81 years for evaluationof possible AIHA. We screened patients by performing direct and indirect antiglobulin tests(DAT and IAT) and cold agglutinin titre (CAT) levels. Pregnant women or those with historyof blood transfusion in previous three months, DAT positive patients due to Rh and ABOincompatibilities in neonates and IAT positives cases in Rh-negative pregnant women wereexcluded. Results: We evaluated 125 patients who were DAT positive autoimmune hemolyticanemia. About 93(74.4%) were females and 32(25.6%) males with female to male ratio of2.9:1. The mean age of our patients was SD ± 36.73 ± 9.32 years. Our patients commonlypresented, generalized weakness in 33(26.4%), pallor of face and extremities in 22(17.6%)and breathlessness in 20(16%) respectively. On clinical examination, moderate to severeanemia was noted in 100(80%), splenomegaly in 40(32%), hepatosplenomegaly in 28 (22.4%)and no visceromegaly in 30(24%) of our cases. We found 35(28%) with primary and 90(72%)patients due to secondary causes of AIHA. The connective tissue disorders, renal failure andhematological disorders were common causes of secondary AIHA in this study. Conclusion:Our study showed females in their thirties presented with generalized weakness, pallor of faceand extremities and breathlessness. Majority had secondary AIHA due to consecutive tissuedisorders, renal failure and hematological disorders as underlying causes. Doctors must becautious regarding whole blood transfusion as means for treating mild to moderate anemia.

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