Secondary Autoimmune Hemolytic Anemia Research Articles

Autoimmune haemolytic anaemia triggered by Bartonella henselae infection: a case report

Bartonella henselae is a hitherto unidentified cause of autoimmune haemolytic anaemia. Here we report a case of Coombs-negative autoimmune haemolytic anaemia. The episode was preceded by exposure to a cat and a non-specific infectious syndrome. Concomitant serum titres of B. henselae antibodies were indicative of a recent infection. The case report suggests that B. henselae infection can trigger secondary autoimmune haemolytic anaemia.

Treatment of autoimmune hemolytic anemias.

Treatment of autoimmune hemolytic anemias varies depending on whether the patient has autoimmune hemolytic anemia of warm antibody type, cold agglutinin syndrome, paroxysmal cold hemoglobinuria, or autoimmune hemolytic anemia secondary to an underlying disorder. Initial therapy for warm antibody autoimmune hemolytic anemia should be corticosteroids, such as prednisone at conventional doses of 1 to 1.5 mg/kg/d orally. Criteria must be established to determine whether the therapeutic response is adequate, because long-term therapy may lead to significant detrimental side effects. Splenectomy has the advantage over therapeutic options in that it has the potential for complete and long-term remission. The major adverse effect is the syndrome of overwhelming postsplenectomy infection. Other therapeutic options, which are less likely to have long-term benefit, are immunosuppressive drugs, danazol, intravenous immunoglobulin, and plasma exchange. Therapy of cold agglutinin syndrome often is unsatisfactory. All patients should avoid exposure to cold, and if additional therapy is necessary, the therapies used for warm antibody autoimmune hemolytic anemia may be tried with less likelihood of response. Paroxysmal cold hemoglobinuria requires aggressive supportive therapy, generally supplemented by corticosteroids. Hemolysis usually terminates spontaneously. Patients with secondary autoimmune hemolytic anemia may be treated similarly to those with idiopathic autoimmune hemolytic anemia, and additional therapy for the underlying disorder also may result in remission of the hemolysis.

The haematological consequences of immune-mediated anaemia in the dog

Haematological findings, at presentation, in 35 cases of canine autoimmune haemolytic anaemia (AHA) were documented. A regenerative anaemia was not found in all cases of AHA. The range of haematological findings spanned a spectrum from aplasia, through normocytic/normochromic red cell morphology, to marked regeneration. Primary AHA was compared to secondary AHA with respect to haematological parameters and some differences were recorded: the degree of anaemia being significantly more marked in the primary cases. In some cases, red cell parameters were not considered reliable due to spurious red cell indices being obtained. The haemoglobin value and reticulocyte count in absolute numbers provided accurate data characterising the type of anaemia.

Signification Clinique Du Test De Coombs Direct Dans Les Affections Neoplasiques: Etude De 265 Cas.

Direct Coombs tests were performed in 265 patients with solid tumors, leu-kemias and malignant lymphomas. The frequency of highly positive Coombs tests varied from 5.52 in the solid tumors (13 % for the carcinomas) to 52 % in chronic lymphotic leukemia. A secondary autoimmune hemolytic anemia, without antibody, was present in 2 cases of solid tumors and in one case of Hodgkin's disease. A dubious or slightly positive Coombs test was frequently observed without signs of increased hemolysis. On the other hand, a strongly positive Coombs test was associated with an acute hemolysis in most cases but in patients with macroglobulinemia. Biological tests usually considered as characteristic for secondary hemolytic anemia (reticulocytosis, unconjugated bilirubin, urinary excretion of urobilinogen, serum iron, granulopoiesis/erythropoiesis ratio) have not an unequivocal significance : they may be normal in cases with true hemolytic anemia or abnormal in patients with a normal survival time of the red cells. The presence of more than 2 abnormal tests is however indicative for the diagnosis of hemolytic anemia, especially if there is no liver deficiency.