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{{Autoimmune hemolytic anemia}}
{{Autoimmune hemolytic anemia}}


{{CMG}} '''Assosciate Editor(s)-In-Chief:''' [[User: Prashanthsaddala|Prashanth Saddala M.B.B.S]]
{{CMG}} '''Assosciate Editor(s)-In-Chief:''' [[User: Prashanthsaddala|Prashanth Saddala M.B.B.S]]; {{shyam}}, [[User:Irfan Dotani|Irfan Dotani]] [3]


==Overview==
==Overview==
Autoimmune hemolytic anemia is classified into 3 broad categories. These include warm-[[antibody]] type, cold-antibody type, and mixed-antibody type. Each category is characterized by a different [[autoantibody]] ([[IgG]] or [[IgM]]) and different optimal binding temperatures (37 degrees Celsius or 4-18 degrees Celsius). Each condition is associated with different triggers, including [[infections]], [[medications]], and [[malignancies]]. The warm-antibody type is the most common, and the mixed-antibody type is rare and not well characterized.


==Classification==
==Classification==
Haemolysis can be intravascular or extravascular.


'''Intravascular haemolysis'''<br>
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center"
Red blood cell lysis occurs in the circulation as a result of activation of the [[complement system]] cascade.
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'''Extravascular haemolysis'''<br>
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Category}}
Red Blood Cells that are coated with antibodies are specifically recognised in the [[reticuloendothelial system]] and destroyed by [[macrophages]].
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Subtypes}}
|-
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Warm-antibody type
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*Accounts for ~75% of cases of autoimmune hemolytic anemia
*Due to IgG autoantibody<ref name="pmid23645992">{{cite journal| author=Palla AR, Khimani F, Craig MD| title=Warm Autoimmune Hemolytic Anemia with a Direct Antiglobulin Test Positive for C3 and Negative for IgG: A Case Study and Analytical Literature Review of Incidence and Severity. | journal=Clin Med Insights Case Rep | year= 2013 | volume= 6 | issue=  | pages= 57-60 | pmid=23645992 | doi=10.4137/CCRep.S11469 | pmc=3623608 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23645992  }} </ref>
*Binding occurs optimally at 37 degrees Celsius
*Extravascular hemolysis (reticuloendothelial system)
| style="padding: 5px 5px; background: #F5F5F5;" |
*Idiopathic
*[[Systemic lupus erythematosus]]
*[[Evans' syndrome]]<ref name="pmid28292089">{{cite journal| author=Bechir A, Haifa R, Nesrine BS, Emna B, Senda M, Asma A et al.| title=Multiple myeloma associated with an Evan's syndrome. | journal=Pan Afr Med J | year= 2016 | volume= 25 | issue=  | pages= 127 | pmid=28292089 | doi=10.11604/pamj.2016.25.127.10750 | pmc=5325491 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28292089  }} </ref>
*[[Chronic lymphocytic leukemia]]
*[[Non-Hodgkin lymphoma]]
*Drugs ([[methyldopa]])
|-
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Cold-antibody type
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*Accounts for ~25% of cases of autoimmune hemolytic anemia
*Due to IgM autoantibody
*Binding occurs optimally at 4-18 degrees Celsius
*Intravascular hemolysis
*Recognition by the reticuloendothelial system
*Destruction by macrophages
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Cold agglutinin disease]]<ref name="pmid24143001">{{cite journal| author=Randen U, Trøen G, Tierens A, Steen C, Warsame A, Beiske K et al.| title=Primary cold agglutinin-associated lymphoproliferative disease: a B-cell lymphoma of the bone marrow distinct from lymphoplasmacytic lymphoma. | journal=Haematologica | year= 2014 | volume= 99 | issue= 3 | pages= 497-504 | pmid=24143001 | doi=10.3324/haematol.2013.091702 | pmc=3943313 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24143001  }} </ref>
*[[Paroxysmal cold hemoglobinuria]]<ref name="pmid18747599">{{cite journal| author=Moncrieff RE| title=Paroxysmal cold hemoglobinuria-1975. | journal=West J Med | year= 1975 | volume= 123 | issue= 6 | pages= 477 | pmid=18747599 | doi= | pmc=1130418 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18747599  }} </ref>
*[[Mycoplasma infection]]<ref name="pmid26696800">{{cite journal| author=Packman CH| title=The Clinical Pictures of Autoimmune Hemolytic Anemia. | journal=Transfus Med Hemother | year= 2015 | volume= 42 | issue= 5 | pages= 317-24 | pmid=26696800 | doi=10.1159/000440656 | pmc=4678314 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26696800 }} </ref>
*[[Malignancy]]
|-
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Mixed warm-antibody and cold-antibody type
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*Due to IgM subtype
*Mixed features
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Systemic lupus erythematosus]]
*Various clinical entities
*Generally rare
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{Hematology}}


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[[Category:Autoimmune diseases]]
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assosciate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S; Shyam Patel [2], Irfan Dotani [3]

Overview

Autoimmune hemolytic anemia is classified into 3 broad categories. These include warm-antibody type, cold-antibody type, and mixed-antibody type. Each category is characterized by a different autoantibody (IgG or IgM) and different optimal binding temperatures (37 degrees Celsius or 4-18 degrees Celsius). Each condition is associated with different triggers, including infections, medications, and malignancies. The warm-antibody type is the most common, and the mixed-antibody type is rare and not well characterized.

Classification
Category Features Subtypes

Warm-antibody type

  • Accounts for ~75% of cases of autoimmune hemolytic anemia
  • Due to IgG autoantibody[1]
  • Binding occurs optimally at 37 degrees Celsius
  • Extravascular hemolysis (reticuloendothelial system)

Cold-antibody type

  • Accounts for ~25% of cases of autoimmune hemolytic anemia
  • Due to IgM autoantibody
  • Binding occurs optimally at 4-18 degrees Celsius
  • Intravascular hemolysis
  • Recognition by the reticuloendothelial system
  • Destruction by macrophages

Mixed warm-antibody and cold-antibody type

  • Due to IgM subtype
  • Mixed features

References

  1. ↑ Palla AR, Khimani F, Craig MD (2013). "Warm Autoimmune Hemolytic Anemia with a Direct Antiglobulin Test Positive for C3 and Negative for IgG: A Case Study and Analytical Literature Review of Incidence and Severity". Clin Med Insights Case Rep. 6: 57–60. doi:10.4137/CCRep.S11469. PMC 3623608. PMID 23645992.
  2. ↑ Bechir A, Haifa R, Nesrine BS, Emna B, Senda M, Asma A; et al. (2016). "Multiple myeloma associated with an Evan's syndrome". Pan Afr Med J. 25: 127. doi:10.11604/pamj.2016.25.127.10750. PMC 5325491. PMID 28292089.
  3. ↑ Randen U, Trøen G, Tierens A, Steen C, Warsame A, Beiske K; et al. (2014). "Primary cold agglutinin-associated lymphoproliferative disease: a B-cell lymphoma of the bone marrow distinct from lymphoplasmacytic lymphoma". Haematologica. 99 (3): 497–504. doi:10.3324/haematol.2013.091702. PMC 3943313. PMID 24143001.
  4. ↑ Moncrieff RE (1975). "Paroxysmal cold hemoglobinuria-1975". West J Med. 123 (6): 477. PMC 1130418. PMID 18747599.
  5. ↑ Packman CH (2015). "The Clinical Pictures of Autoimmune Hemolytic Anemia". Transfus Med Hemother. 42 (5): 317–24. doi:10.1159/000440656. PMC 4678314. PMID 26696800.


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