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2.
Rev Med Suisse ; 16(714): 2183-2187, 2020 Nov 11.
Artículo en Francés | MEDLINE | ID: mdl-33174702

RESUMEN

Autoimmune hemolytic anemia is an uncommon disease that can be challenging to manage both for the emergency department physician and the general practitioner. The diagnosis is based on specific biological changes and on a positive direct Coombs test. Depending on the severity of the anemia and its clinical impact, an urgent blood transfusion can be required. However, ABO blood group typing and antibody screening may be impaired by autoantibodies. In case of vital need, a transfusion of ABO, Rh D and, if possible, C, c, E, e and Kell antigen matched red cells can be performed, before the complete achievement of the pre-transfusion testing. Further management includes the introduction of immunosuppression and the treatment of a possible underlying disease. Early contact with the hematologist, is strongly recommended.


Asunto(s)
Anemia Hemolítica Autoinmune , Servicio de Urgencia en Hospital , Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/epidemiología , Anemia Hemolítica Autoinmune/terapia , Autoanticuerpos , Tipificación y Pruebas Cruzadas Sanguíneas , Transfusión Sanguínea , Prueba de Coombs , Humanos
3.
Vnitr Lek ; 66(4): 47-52, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32972184

RESUMEN

IgG4 related disease (IgG4-RD) is a rare and relatively new group of systemic inflammatory diseases characterized by inflammatory, fibrotic or sclerotic involvement of one or more organs accompanied by increased IgG4plasma cells tissue infiltration andusually elevated serum IgG4(IgG4 > 1.35g/l, normal range 0.08-1.40 g/l) level. Histopathological findings are crucial for the diagnostics of this disease. The authors present a case report of a patient with IgG4 associated disease manifested by a rare combination of autoimmune hemolytic anemia and pulmonary involvement.


Asunto(s)
Anemia Hemolítica Autoinmune , Enfermedades Autoinmunes , Enfermedades Pulmonares , Anemia Hemolítica Autoinmune/complicaciones , Anemia Hemolítica Autoinmune/diagnóstico , Enfermedades Autoinmunes/complicaciones , Humanos , Inmunoglobulina G , Enfermedades Pulmonares/complicaciones
4.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 739-744, 2020 Jun 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-32879133

RESUMEN

IgG4-related disease (IgG4-RD) is a rare autoimmune fibrosis disease characterized by elevated serum IgG4 and tissues as well as organs infiltrated with IgG4-positive cells, resulting in swelling and damage.It is currently treated as first-line treatment with glucocorticoids. Autoimmune hemolytic anemia (AIHA) is also a relatively rare disease that caused by autoreactive erythrocyte antibodies. Although both are autoimmune-related diseases, they rarely overlap. The relationship between them is not clear. A case of IgG4-RD combined with AIHA is reported. The patient has shortness of breath, cough, and sputum after physical activity. Physical examination showed appearance of anemia, yellow staining of skin and sclera, palpable neck and multiple swollen lymph nodes. Laboratory examination, bone marrow biopsy, and lymph node biopsy confirmed the diagnosis. Therefore, clinicians should develop ideas and raise awareness of such diseases.


Asunto(s)
Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/tratamiento farmacológico , Enfermedades Autoinmunes/complicaciones , Enfermedad Relacionada con Inmunoglobulina G4/complicaciones , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico , Biopsia , Humanos , Inmunoglobulina G
5.
J Stroke Cerebrovasc Dis ; 29(8): 104924, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32689602

RESUMEN

Dabigatran is an orally active direct thrombin inhibitor, initially approved by FDA for the prophylaxis of stroke and systemic embolism in the setting of non-valvular atrial fibrillation (NVAF). Major bleeding is its most common adverse event which is of great concern. However, other types of adverse events such as esophagitis, esophageal ulcer, exanthem and pustular eruptions were reported increasingly in recent years. We present a case of immune hemolytic anemia (IHA) due to dabigatran use in a 72-year-old male with NVAF. This new and rare reported type of adverse event associated with dabigatran suggests that dabigatran may be a new cause of drug-induced immune hemolytic anemia (DIIHI).


Asunto(s)
Anemia Hemolítica Autoinmune/inducido químicamente , Antitrombinas/efectos adversos , Dabigatrán/efectos adversos , Anciano , Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/tratamiento farmacológico , Anemia Hemolítica Autoinmune/inmunología , Antitrombinas/administración & dosificación , Enfermedad Crónica , Dabigatrán/administración & dosificación , Progresión de la Enfermedad , Sustitución de Medicamentos , Glucocorticoides/administración & dosificación , Humanos , Inmunoglobulinas Intravenosas/administración & dosificación , Masculino , Resultado del Tratamiento , Warfarina/administración & dosificación
9.
Rev. cuba. hematol. inmunol. hemoter ; 36(2): e1098, abr.-jun. 2020. tab, graf
Artículo en Español | LILACS, CUMED | ID: biblio-1149894

RESUMEN

Introducción: La membrana de los eritrocitos, al igual que las membranas de otros tipos celulares, está compuesta por una bicapa lipídica que es estabilizada por proteínas específicas, glucolípidos y otras moléculas especializadas. Las mutaciones producidas en los genes que codifican y regulan estas proteínas y sus interacciones producen cambios en la forma de los eritrocitos y son causa de anemias hemolíticas hereditarias. Objetivo: Describir las peculiaridades moleculares, clínicas y el diagnóstico de laboratorio de las principales anemias hemolíticas hereditarias por defectos en la membrana de los eritrocitos. Métodos: Se realizó una revisión de la literatura, en inglés y español, a través del sitio web PubMed y el motor de búsqueda Google académico de artículos publicados en los últimos 10 años. Se hizo un análisis y resumen de la bibliografía revisada. Análisis y síntesis de la información: Las mutaciones que afectan la membrana de los eritrocitos son variadas y heterogéneas. El efecto sobre el fenotipo puede ser clasificado en cinco categorías principales: esferocitosis hereditaria; eliptocitosis hereditaria y piropoiquilocitosis hereditaria; ovalocitosis del sureste asiático; acantocitosis hereditaria y estomatocitosis hereditaria. Conclusiones: La cuidadosa observación de la morfología de los eritrocitos en extendidos de sangre periférica y los estudios moleculares permiten realizar un diagnóstico certero, además de confirmar la correlación genotipo/fenotipo en estas enfermedades(AU)


Introduction: The erythrocyte membrane, like the membranes of other cell types, is composed of a lipid bilayer that is stabilized by specific proteins, glycolipids and other specialized molecules. Mutations in the genes that encode and regulate these proteins and their interactions cause changes in the shape of erythrocytes and are the cause of hereditary hemolytic anemias. Objective: To describe the molecular and clinical peculiarities and the laboratory diagnosis of the main hereditary hemolytic anemias due to defects in the erythrocyte membrane. Methods: A literature review was carried out, in English and in Spanish, through the PubMed website and the Google Scholar search engine, of articles published in the last ten years. An analysis and summary of the revised bibliography was made. Information analysis and synthesis: Mutations affecting the erythrocyte membrane are varied and heterogeneous. The effect on the phenotype can be classified into five main categories: hereditary spherocytosis, hereditary elliptocytosis and hereditary pyropoikilocytosis, Southeast Asian ovalocytosis, hereditary acantocytosis, and hereditary stomatocytosis. Conclusions: Careful observation of erythrocyte morphology in peripheral blood smears and molecular studies allow an accurate diagnosis, in addition to confirming the genotype-phenotype correlation in these diseases(AU)


Asunto(s)
Fenotipo , Genotipo , Anemia Hemolítica Autoinmune/diagnóstico
10.
Med. clín (Ed. impr.) ; 154(9): 331-337, mayo 2020. tab
Artículo en Español | IBECS | ID: ibc-193212

RESUMEN

INTRODUCCIÓN: Las anemias hemolíticas autoinmunes (AHAI) son enfermedades poco frecuentes y heterogéneas en su fisiopatología y comportamiento clínico, siendo el manejo de las mismas fundamentalmente empírico. PACIENTES Y MÉTODOS: Realizamos un estudio observacional, retrospectivo y multicéntrico de 93 pacientes diagnosticados de AHAI en 9 hospitales españoles entre 1987 y 2017, con una mediana de seguimiento de 28 meses. RESULTADOS: Mediana de edad de 67 años; un 85% de AHAI por anticuerpos calientes y un 64% AHAI primarias. Los valores de hemoglobina más bajos al diagnóstico se relacionaron con edad<45 años y el tipo serológico IgG+C. Un 92% recibieron tratamiento de primera línea, un 54% de segunda línea y un 27% de tercera línea. Las AHAI calientes fueron tratadas en primera línea con esteroides, con respuestas globales del 83% y completas del 58%. El rituximab en monoterapia o asociado a esteroides se administró a 34 pacientes con respuestas globales cercanas al 100% (respuestas completas 40-60%), relegando la esplenectomía a tercera línea. El tratamiento inmunosupresor se administró en pacientes con enfermedades autoinmunes o en dependientes de corticoides. DISCUSIÓN: Encontramos altas tasas de respuesta a esteroides, con tratamientos muy prolongados que provocan efectos secundarios y corticodependencia en un tercio de los pacientes. La asociación de esteroides con rituximab en primera línea podría estar indicada en pacientes con bajos niveles de hemoglobina y tipo serológico IgG+C. Las altas tasas de recaída hacen necesario el desarrollo de estudios aleatorizados con nuevos fármacos o la asociación con los ya existentes, que permitan mayor duración de las respuestas y con menores efectos secundarios


INTRODUCTION: Autoimmune haemolytic anaemia (AIHA) is an infrequent and heterogeneous disease in its pathophysiology and clinical behaviour, therefore it is generally managed empirically. PATIENTS AND METHODS: We conducted an observational, retrospective and multicentre study of 93 patients diagnosed with AHAI in 9 Spanish hospitals between 1987 and 2017, with a median follow-up of 28 months. RESULTS: Median age of 67 years; 85% AHAI for hot antibodies and 64% primary AHAI. The lowest haemoglobin values at diagnosis related to patients under 45 years of age and serological type IgG+C. Of the patients, 92% received first line treatment, 54% second line, and 27% third line. The warm AHAI were treated in first line with steroids, with overall responses of 83% and complete of 58%. Rituximab in monotherapy or in association with steroids was administered to 34 patients with overall responses close to 100% (complete responses 40-60%), relegating splenectomy to the third line. The immunosuppressive treatment was administered in patients with autoimmune diseases or in corticoid-dependent patients. DISCUSSION: We found high rates of response to steroids, with very prolonged treatments that cause side effects and corticoid dependence in a third of patients. The combination of steroids with rituximab in the first line, could be indicated in patients with low levels of haemoglobin and serological type IgG+C. The high relapse rates make necessary the development of randomised studies with new drugs or the combination with existing ones, which allow longer response times and with fewer side effects


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/tratamiento farmacológico , Inmunosupresores , Resultado del Tratamiento , Anemia Hemolítica Autoinmune/fisiopatología , Estudios Retrospectivos , Enfermedades Autoinmunes/tratamiento farmacológico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Glucocorticoides/administración & dosificación
11.
BMC Cardiovasc Disord ; 20(1): 106, 2020 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-32131747

RESUMEN

BACKGROUND: PE (pulmonary embolism) is a life-threatening complication rarely seen in the AIHA (autoimmune haemolytic anaemia) patients. Herein we reported a rare and serious AIHA-PE patient characterised by extensive peripheral pulmonary embolism on CTPA. CASE PRESENTATION: A 59-year-old woman presented to our ED (emergency department) complaining of acute chest pain and dyspnea. During her presentation in ED she experienced a sudden syncope and soon developed CA (cardiac arrest). Laboratory studies showed a increase of CK-MB,troponin T,myoglobin and D-dimer. Computed tomography pulmonary angiography (CTPA) showed no large central or segment pulmonary emboli but increased RV (right ventricle)size,enlarged main pulmonary artery and invisible peripheral pulmonary artery. She was diagnosed with acute PE and alteplase was delivered intravenously. After thrombolytic therapy she remained hypotension and developed worsening anaemia. Detailed examination for anaemia revealed AIHA. She was discharged in a stable condition after 5 weeks with methylprednisolone and warfarin. Hb, D-dimer and transthoracic echocardiography showed complete recovery at 3-months follow up. CONCLUSION: PE attributed to AIHA is characterized by subsegment and distal pulmonary artery embolism which is easily neglected but always life-threatening. This case also highlights the PE as a secondary diagnosis should be evaluated comprehensively in order to identify the underlying pathogenesis.


Asunto(s)
Anemia Hemolítica Autoinmune/complicaciones , Embolia Pulmonar/etiología , Enfermedad Aguda , Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/tratamiento farmacológico , Anticoagulantes/uso terapéutico , Femenino , Fibrinolíticos/administración & dosificación , Glucocorticoides/uso terapéutico , Humanos , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/tratamiento farmacológico , Choque Cardiogénico/etiología , Síncope/etiología , Terapia Trombolítica , Activador de Tejido Plasminógeno/administración & dosificación , Resultado del Tratamiento , Warfarina/uso terapéutico
14.
Medicine (Baltimore) ; 99(6): e18984, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028408

RESUMEN

RATIONALE: Autoimmune hemolytic AQ5 anemia (AIHA) is an immune disorder caused by antibodies directed against unmodified autologous red blood cells. In rare cases, AIHA is comorbid with other immunological disorders; for instance, when AIHA is complicated with immunologic thrombocytopenic purpura (ITP) it is called Evans Syndrome (ES). These multiple autoimmune mechanisms are referred to as "immunological tolerance loss," which is known as a characteristic autoimmunity specific for AIHA. And there are no estimation of the risk for thromboembolism in the "immunological tolerance loss" case. PATIENT CONCERNS: A 66-year-old man was diagnosed with ES after autologous stem cell transplantation for malignant lymphoma. His background immunological status was complicated because AIHA was mixed-type (warm and cold antibody type). The direct/indirect Coombs tests were positive. The anticomplement antibody was positive and his cold hemagglutinin level had increased. Anticardiolipin antibodies were negative: anticardiolipin ß2GPI antibody ≤1.2 U/mL (<3.5), anticardiolipin immunoglobulin G antibody ≤8 U/mL (<10), and anticardiolipin immunoglobulin M antibody ≤5 U/mL (<8). DIAGNOSES: ITP and mixed-type AIHA. INTERVENTIONS: The patient achieved complete response by initial prednisolone therapy; however, he did not respond to corticosteroid therapy after AIHA recurrence. He required the red blood cell transfusion due to the progression of hemolytic anemia. OUTCOMES: On the fourth day of refractory treatment following AIHA recurrence, the patient had acute respiratory failure with severe hypoxia and died. The cause of death was identified as pulmonary embolism (PE) based on the laboratory data and echocardiography findings, and a literature search suggested rapidly progressive hemolysis-induced PE. LESSONS: Although infrequent, comorbid thromboembolism to AIHA is well documented; however, a mixed-type AIHA case complicated with thromboembolism has not been previously reported. The combined pathophysiology of AIHA and thromboembolism should be considered in the clinical course of hemolysis. Our case suggested multiple immunological background, ITP, and mixed type AIHA, could be associated to a risk for thromboembolism (TE).


Asunto(s)
Anemia Hemolítica Autoinmune/complicaciones , Embolia Pulmonar/etiología , Anciano , Anemia Hemolítica Autoinmune/diagnóstico , Resultado Fatal , Humanos , Masculino , Embolia Pulmonar/diagnóstico , Púrpura Trombocitopénica Idiopática/complicaciones , Púrpura Trombocitopénica Idiopática/diagnóstico , Trombocitopenia/complicaciones , Trombocitopenia/diagnóstico
15.
Acta Haematol ; 143(5): 491-495, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31962320

RESUMEN

Thymoma is an uncommon neoplasia derived from the epithelial cells of the thymus, which leads to immune dysregulation and is associated with a series of autoimmune diseases. However, the concurrence of these disease entities is rare, and the exact mechanisms of these diseases are still unclear. We have admitted several cases who were diagnosed with thymoma, autoimmune haemolytic anaemia, and pure red cell aplasia. These cases were the first to report the concurrence of these three disorders. After thymectomy, anaemia improved, haemolytic cells decreased, and haemoglobin was normalized.


Asunto(s)
Anemia Hemolítica Autoinmune/diagnóstico , Aplasia Pura de Células Rojas/diagnóstico , Neoplasias del Timo/diagnóstico , Corticoesteroides/uso terapéutico , Adulto , Anciano , Anemia Hemolítica Autoinmune/tratamiento farmacológico , Anemia Hemolítica Autoinmune/etiología , Médula Ósea/patología , Transfusión de Eritrocitos , Femenino , Hemoglobinas/análisis , Humanos , Masculino , Persona de Mediana Edad , Aplasia Pura de Células Rojas/terapia , Tórax/diagnóstico por imagen , Neoplasias del Timo/complicaciones , Tomografía Computarizada por Rayos X
16.
Transfusion ; 60(1): 175-183, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31850521

RESUMEN

BACKGROUND: Rhesus D (RhD) incompatibility is still the most important cause of hemolytic disease of the fetus and newborn (HDFN) worldwide. The aim of this study was to investigate the incidence, causes, and consequences of anti-D alloimmunizations in pregnancy in Iceland, prior to implementation of targeted routine antenatal anti-D prophylaxis (RAADP) in 2018. STUDY DESIGN AND METHODS: This was a nation-wide cohort study of 130 pregnancies affected by RhD alloimmunization in Iceland in the period from 1996 through 2015. Data were collected from transfusion medicine databases, medical records, and the Icelandic Medical Birth Register. RESULTS: Of 130 RhD alloimmunizations, 80 cases (61.5%) represented new RhD immunization in the current pregnancy. Sensitization was discovered in the third trimester in 41 (51.3%) and occurred in the first pregnancy in 14 cases (17.5%). The most likely causative immunization event was the index pregnancy for 45 (56.25%), a previous pregnancy/birth for 26 (32.5%), abortion for 3 (3.75%), and unknown for 6 women (7.5%). Higher anti-D titers were associated with shorter gestational length, cesarean sections, positive direct antiglobulin test (DAT), and severe HDFN. Intrauterine transfusion (IUT) was performed in five pregnancies (3.8%), and 35 of 132 (26.5%) live-born neonates received treatment for HDFN; 32 received phototherapy (24.2%), 13 exchange transfusion (9.8%), and seven simple blood transfusion (5.3%). CONCLUSION: In about half of cases, RhD alloimmunization was caused by the index pregnancy and discovered in the third trimester. Thus, the newly implemented RAADP protocol should be effective in reducing the incidence of RhD immunization in Iceland in the future.


Asunto(s)
Transfusión de Sangre Intrauterina , Nacimiento Vivo , Diagnóstico Prenatal , Isoinmunización Rh , Globulina Inmune rho(D)/sangre , Adulto , Anemia Hemolítica Autoinmune/sangre , Anemia Hemolítica Autoinmune/diagnóstico , Anemia Hemolítica Autoinmune/epidemiología , Anemia Hemolítica Autoinmune/prevención & control , Femenino , Humanos , Islandia , Recién Nacido , Embarazo , Estudios Retrospectivos , Isoinmunización Rh/sangre , Isoinmunización Rh/diagnóstico , Isoinmunización Rh/epidemiología , Isoinmunización Rh/prevención & control
17.
J Pediatr Hematol Oncol ; 42(4): e244-e247, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31033790

RESUMEN

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organ systems. Patients can have hematologic manifestations, including Evans syndrome (ES), which is characterized by immune-mediated thrombocytopenia and anemia. The association of neurofibromatosis 1 (NF1) with autoimmune disorders is rarely reported. We will review the literature for this combination of disorders and describe a case of a 16-year-old girl who presents with immune-mediated cytopenias and is diagnosed with SLE, ES, and NF1. There are 7 reported cases of SLE and NF1 and only 2 are pediatric cases. There are no reports of the combination of SLE, ES, and NF1.


Asunto(s)
Anemia Hemolítica Autoinmune , Lupus Eritematoso Sistémico , Neurofibromatosis 1 , Trombocitopenia , Adolescente , Anemia Hemolítica Autoinmune/sangre , Anemia Hemolítica Autoinmune/complicaciones , Anemia Hemolítica Autoinmune/diagnóstico , Femenino , Humanos , Lupus Eritematoso Sistémico/sangre , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Neurofibromatosis 1/sangre , Neurofibromatosis 1/complicaciones , Neurofibromatosis 1/diagnóstico , Trombocitopenia/sangre , Trombocitopenia/complicaciones , Trombocitopenia/diagnóstico
18.
BMJ Case Rep ; 12(12)2019 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-31811095

RESUMEN

Increasing numbers of patients are now offered immunotherapy as part of their cancer treatment. These treatments, while often very effective, have a wide range of adverse effects that are distinct from those of traditional chemotherapy regimens. Thyroid disease, dermatological disease, colitis and pneumonitis are some of the most commonly reported immune side effects. We present a case of life-threatening de novo autoimmune haemolytic anaemia (AIHA) complicated by immune cholangitis induced by pembrolizumab. An 81-year-old woman with metastatic melanoma completed a two-year course of pembrolizumab in August 2018 and six weeks later presented to hospital with jaundice. Admission haemoglobin (Hb) was 91 g/L, rapidly decreasing to 31 g/L, at which point she required admission to the intensive care unit. AIHA is a rare but potentially life-threatening complication of checkpoint inhibitors and should be considered in patients presenting with anaemia during or after immunotherapy treatment.


Asunto(s)
Anemia Hemolítica Autoinmune/diagnóstico , Anticuerpos Monoclonales Humanizados/efectos adversos , Antineoplásicos Inmunológicos/efectos adversos , Colangitis/diagnóstico , Anciano de 80 o más Años , Anemia Hemolítica Autoinmune/sangre , Anemia Hemolítica Autoinmune/inducido químicamente , Anemia Hemolítica Autoinmune/complicaciones , Colangitis/sangre , Colangitis/inducido químicamente , Colangitis/complicaciones , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Melanoma/tratamiento farmacológico , Melanoma/secundario , Metástasis de la Neoplasia , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patología
19.
Rev Med Chil ; 147(7): 836-841, 2019 Jul.
Artículo en Español | MEDLINE | ID: mdl-31859981

RESUMEN

BACKGROUND: Autoimmune hemolytic anemia (AIHA) is an uncommon disease. In its presentation, it can be severe and even lethal. There is only one clinical report concerning this pathology in Chile. OBJECTIVE: To describe the clinical characteristics and evolution of adult AIHA inpatients. MATERIALS AND METHODS: Retrospective review of clinical records of adult AIHA inpatients between January 2010 and June 2018 was done. Demographic, clinical, laboratory and therapeutic information was analyzed. A descriptive, analytical and survival analysis was performed. RESULTS: Forty-three adult patients diagnosed with AHIA were hospitalized in a period of 8 years. Median age was 63 years (range 22-86 years), mostly women (72%). Warm antibodies were detected in 36 cases (84%) and cold antibodies in seven. Seventy two percent of the patients had an underlying cause, and 58% were secondary to lymphoproliferative neoplasms. All patients except two, received steroids as initial treatment, with response in 37 (90%) of them. Three refractory patients received rituximab, with response in all of them, and relapse in one. Median follow-up was 38 months (range 2-98 months). Five year overall survival was 72%. CONCLUSION: AHIA in adults inpatients is a heterogeneous disease, mainly due to warm antibodies, and to secondary etiology.


Asunto(s)
Anemia Hemolítica Autoinmune/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Anemia Hemolítica Autoinmune/mortalidad , Anemia Hemolítica Autoinmune/terapia , Azatioprina/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Rituximab/administración & dosificación , Esplenectomía , Análisis de Supervivencia , Adulto Joven
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