Spectrum of immune haemolysis in children

ABSTRACT

Immune haemolysis is frequently encountered in paediatric age group. A correct diagnosis is important for management and prevention and must be performed on samples obtained before initiation of any therapy. This study was carried out on newly diagnosed patients to correctly assess the magnitude of problem. We investigated all patients of suspected immune haemolysis referred to Armed Forces Institute of Pathology [AFIP] from all military hospitals and most of the civil hospitals in Rawalpindi. Relevant aetiological investigations were carried out in each case. Nine patients of less than 15 years age were seen during one year period of study, 3 patients with alloimmune antibody and 6 with autoantibody. These do not include cases of haemolytic disease of newborn [HDN]. In 3 patients of alloimmune haemolysis antibody developed after multiple transfusions. Anti-c antibody was detected in 02 patients and anti Lea in one patient. There were 6 patients with autoimmune haemolysis. Two were of cold antibody type with anti-I specificity, two of warm antibody type with pan-reactive antibody and 2 were with mixed cold and warm antibodies. Warm component was anti-K in one patient and pan-reactive antibody in other patient. Anti-I was detected as cold component in both patients