Keywords
Autoimmune hemolytic anemia, autoantibodies, direct antiglobulin monospecific test
How to Cite
TORO ESPINOSA, L. A., & JARAMILLO ARBELAEZ, P. E. (2020). Characterization of autoimmune hemolytic anemia and usefulness of the monospecific direct antiglobulin test for diagnosis. Journal of Hematology, 24(2), 55–64. Retrieved from https://revistahematologia.com.ar/index.php/Revista/article/view/246
Abstract
Autoimmune hemolytic anemia (AIHA) is a clinical condition characterized by autoantibody-mediated hemolysis with or without activation of the complement system. Several mechanisms are considered responsible for autoantibody genesis and hemolysis; for example, the alterations in the environment of cell ontogeny and maturation, and the antigen processing. However, hemolysis of immune origin is only one cause of hemolytic anemia, among others.
It is estimated that two-thirds of the cases of AIHA are secondary conditions and accompany other hematological pathologies. In recent decades, the understanding of the nature of immune complexes composed by IgG, IgM, IgA and complement fractions has provided relevant information for the treatment and prognosis of patients. This review aims to describe the basic concepts and classification of AIHA, to identify the usefulness of the monospecific direct antiglobulin test in the detection of immune complexes associated with the disease and, finally, to describe the relationship between AIHA and other hematological pathologies.
References
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11. McQueen F: A B cell explanation for autoimmune disease: the forbidden clone returns. Postgrad Med J. 2012;88:226–233.
12. Smirnova SJ, Sidorova J V, et al. Expansion of CD8+ cells in autoimmune hemolytic anemia. Autoimmunity. 2016;49(3):147–54.
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22. Agramonte M, Montero A, Galan L, Gonzalez A, Cristo V. Caracterización clinica y de laboratorio de la
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23. Packman C. The clinical pictures of autoimmune hemolytic anemia. Transfus med hemother 2015;42:317-
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25. Zhou, J. , Wu, M. , et al. Clinical analysis of 20 patients with non-Hodgkin lymphoma and autoimmune hemolytic anemia. 2020; 99 (7), p e19015
26. Kashyap R, Singh A, Kumar P. Prevalence of autoimmune hemolytic anemia in multiple myeloma: A prospective study. Asia Pac J Clin Oncol. 2016;12(2):e319–22.
27. Muñoz Ibarra E.L. et al. Anemia hemolítica en el síndrome paraneoplásico en carcinoma de células renales. Rev Mex Urol 2013;73(2):92-95
28. Loh KP, Kansagra A, Asik A, Ali S, Dahiya S. Paraneoplastic autoimmune hemolytic anemia in ovarian cancer: A marker of disease activity. Rare Tumors. 2015;7(1):4–7.
29. Knief J, Reddemann K, et al. High Density of Tumor-infiltrating B-Lymphocytes and Plasma Cells Signifies Prolonged Overall Survival in Adenocarcinoma of the Esophagogastric Junction. Anticancer Res . 2016;36(10):5339–46.
30. Agrawal K, Alfonso F, Report C. Case Report A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma. 2017;2017:5–10.
31. Aggarwal A. Role of autoantibody testing. Best Pract Res Clin Rheumatol 2014;28(6):907–20.
32. Graus F, Saiz A, Dalmau J. Antibodies and neuronal autoimmune disorders of the CNS. J Neurol. 2010;257(4):509–17.
33. Naithani, R., & Dayal, N. (2020). Autoimmune Hemolytic Anemia as Presenting Manifestation of Multiple Myeloma. Indian J of Hematol Blood Transf. 2020. doi:10.1007/s12288-019-01252-0
34. Troselj-Vukic B, Milotic I, Milotic F, Crnic-Martinovic M, Grahovac B. Cytomegalovirus reactivation after low-dose steroid treatment for hemolytic anemia in a patient with primary Epstein-Barr virus infection. Wien Klin Wochenschr. 2007;119(13–14):435–7.
35. Vukijc T et al. Cytomegalovirus reactivation after lowdose steroid treatment for hemolytic anemia in a patient with primary Epstein-Barr virus infection. Wien Klin Wochenschr 2007 119/13–14: 435–437
36. Melo CLS, Sanguino SIJ, et al. Anemia hemolítica autoinmune postinfección por virus de la Hepatitis A. Reporte de caso. MedUNAB. 2010;13(3):173–6.
37. Ozbay Hosnut F, Ozcay F, et al. Etiology of hemolysis in two patients with hepatitis A infection: Glucose-6-phosphate dehydrogenase deficiency or autoimmune hemolytic anemia. Eur J Pediatr. 2008;167(12):1435–9.
38. Zikidou P, Grapsa A, et al. Parvovirus B19-triggered Acute Hemolytic Anemia and Thrombocytopenia in a Child with Evans Syndrome. Mediterr J Hematol Infect Dis 2018;10(1):e2018018.
2. Packman CH. The spherocytic haemolytic anaemias. Br J Haematol 2001;112:888–99.
3. Chaudhary R, Das S. Autoimmune hemolytic anemia: From lab to bedside. Asian J Transfus Sci [Internet]. 2014;8(1):5.
4. Dameshek W, Schwartz SO. Acute hemolytic anemia (acquired hemolytic icterus, acute type). Medicine 1940;19:231–327.
5. Pierce R, Reid M. Bloody Brilliant: a history of bloog groups and blood groupers. AABB. 2016
6. Usher R, Coombs R, Fox JB, Spencer HB. Obituaries. (February) 2006;332.
7. Rattarittamrong E, Eiamprapai P, et al. Clinical characteristics and long-term outcomes of warm-type autoimmune hemolytic anemia. Hematology [Internet]. 2016;5332(August):1–7.
8. Lebien TW, Tedder TF. B lymphocytes: How they develop and function. Blood. 2008;112(5):1570–80.
9. Fagiolo, E., and C. Toriani-Terenzi. 2003. Mechanisms of immunological tolerance loss versus erythrocyte self-antigens and autoimmune hemolytic anemia. Autoimmunity. 36: 199–204. Review.
10. Barcellini W. New insights in the pathogenesis of autoimmune hemolytic anemia. Transfus Med Hemother 2015;42:287-293.
11. McQueen F: A B cell explanation for autoimmune disease: the forbidden clone returns. Postgrad Med J. 2012;88:226–233.
12. Smirnova SJ, Sidorova J V, et al. Expansion of CD8+ cells in autoimmune hemolytic anemia. Autoimmunity. 2016;49(3):147–54.
13. Lange K, Gold MM, et al. Autoantibodies in human glomerulonephritis., J Clin Invest, 1949, vol. 28 (pg. 50-55)
14. Fagiolo E, Toriani-Terenzi C. Th1 and Th2 cytokine modulation by IL-10/IL-12 imbalance in autoimmune haemolytic anaemia (AIHA). Autoimmunity. 2002;35(1):39–44.
15. Wu J, Li X, et al. The roles and applications of autoantibodies in progression, diagnosis, treatment and prognosis of human malignant tumours. Vol. 16, Autoimmunity Reviews. 2017. p. 1270–81.
16. Palla AR, Khimani F, Craig MD. 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 Reports. 2013;6:57–60.
17. Puthenparambil J, Lechner K, Kornek G. Autoimmune hemolytic anemia as a paraneoplastic phenomenon in solid tumors: A critical analysis of 52 cases reported in the literature. Wien Klin Wochenschr. 2010;122(7–8):229–36.
18. Cortés A, Muñiz M. Inmunohematología básica y aplicada. Primera Edición. GCIAMT.2014 19. Gutiérrez Jomarrón I, López Rubio M, et al. Anemias hemolíticas autoinmunes: estudio retrospectivo de 93 pacientes. Medicina Clinica. 2020;154(9):331–7.2.
20. Bencomo-hernández DAA, Alfonso-valdés DME, Onel M. Relación entre hemólisis con la presencia y cuantificación de inmunoglobulinas en hematíes , en la anemia hemolítica autoinmune Relation between hemolysis with presence and quantification of immunoglobulin in red blood cells in cases of autoimmune hemolyt. 2010;26(4):315–27.
21. Sekhar Das Sudipta. Clinical and serological characterization. Annals of Hematology 88(8):727-32 • February 2009
22. Agramonte M, Montero A, Galan L, Gonzalez A, Cristo V. Caracterización clinica y de laboratorio de la
anemia hemolitica autoinmune: estudio retrospectivo de 15 casos. Rev Cuba Hematol Inmunol y Hemoter [Internet]. 2015;31(4):426–33.
23. Packman C. The clinical pictures of autoimmune hemolytic anemia. Transfus med hemother 2015;42:317-
324
24. Visco C, Cortelezzi A, et al. Autoimmune cytopenias in chronic lymphocytic leukemia at disease presentation in the modern treatment era: Is stage C always stage C? Leuk Lymphoma. 2014;55(6):1261–5.
25. Zhou, J. , Wu, M. , et al. Clinical analysis of 20 patients with non-Hodgkin lymphoma and autoimmune hemolytic anemia. 2020; 99 (7), p e19015
26. Kashyap R, Singh A, Kumar P. Prevalence of autoimmune hemolytic anemia in multiple myeloma: A prospective study. Asia Pac J Clin Oncol. 2016;12(2):e319–22.
27. Muñoz Ibarra E.L. et al. Anemia hemolítica en el síndrome paraneoplásico en carcinoma de células renales. Rev Mex Urol 2013;73(2):92-95
28. Loh KP, Kansagra A, Asik A, Ali S, Dahiya S. Paraneoplastic autoimmune hemolytic anemia in ovarian cancer: A marker of disease activity. Rare Tumors. 2015;7(1):4–7.
29. Knief J, Reddemann K, et al. High Density of Tumor-infiltrating B-Lymphocytes and Plasma Cells Signifies Prolonged Overall Survival in Adenocarcinoma of the Esophagogastric Junction. Anticancer Res . 2016;36(10):5339–46.
30. Agrawal K, Alfonso F, Report C. Case Report A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma. 2017;2017:5–10.
31. Aggarwal A. Role of autoantibody testing. Best Pract Res Clin Rheumatol 2014;28(6):907–20.
32. Graus F, Saiz A, Dalmau J. Antibodies and neuronal autoimmune disorders of the CNS. J Neurol. 2010;257(4):509–17.
33. Naithani, R., & Dayal, N. (2020). Autoimmune Hemolytic Anemia as Presenting Manifestation of Multiple Myeloma. Indian J of Hematol Blood Transf. 2020. doi:10.1007/s12288-019-01252-0
34. Troselj-Vukic B, Milotic I, Milotic F, Crnic-Martinovic M, Grahovac B. Cytomegalovirus reactivation after low-dose steroid treatment for hemolytic anemia in a patient with primary Epstein-Barr virus infection. Wien Klin Wochenschr. 2007;119(13–14):435–7.
35. Vukijc T et al. Cytomegalovirus reactivation after lowdose steroid treatment for hemolytic anemia in a patient with primary Epstein-Barr virus infection. Wien Klin Wochenschr 2007 119/13–14: 435–437
36. Melo CLS, Sanguino SIJ, et al. Anemia hemolítica autoinmune postinfección por virus de la Hepatitis A. Reporte de caso. MedUNAB. 2010;13(3):173–6.
37. Ozbay Hosnut F, Ozcay F, et al. Etiology of hemolysis in two patients with hepatitis A infection: Glucose-6-phosphate dehydrogenase deficiency or autoimmune hemolytic anemia. Eur J Pediatr. 2008;167(12):1435–9.
38. Zikidou P, Grapsa A, et al. Parvovirus B19-triggered Acute Hemolytic Anemia and Thrombocytopenia in a Child with Evans Syndrome. Mediterr J Hematol Infect Dis 2018;10(1):e2018018.
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