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Clinical perspectives, immunohematologic insights, and transfusion management in IgA-associated autoimmune hemolytic anemia Cover

Clinical perspectives, immunohematologic insights, and transfusion management in IgA-associated autoimmune hemolytic anemia

Open Access
|Sep 2022

Figures & Tables

Fig. 1

Classification of 348 patients with autoimmune hemolytic anemia (AIHA) based on immunohematologic findings. Ig = immunoglobulin; WAIHA = warm autoimmune hemolytic anemia; CAS = cold agglutinin syndrome; PCH = paroxysmal cold hemoglobinuria; C = complement.
Classification of 348 patients with autoimmune hemolytic anemia (AIHA) based on immunohematologic findings. Ig = immunoglobulin; WAIHA = warm autoimmune hemolytic anemia; CAS = cold agglutinin syndrome; PCH = paroxysmal cold hemoglobinuria; C = complement.

Statistical analysis of in vivo hemolytic markers in study patients with IgA-associated and non-IgA-associated WAIHA (N = 214)

In vivo hemolytic markersIgA-associated WAIHA (N = 17)Non-IgA-associated WAIHA (N = 197)Statistics (t test)
Two-tailed p value95% Confidence interval
Hb (g/dL)5.58 ± 1.076.71 ± 1.160.0001–1.701 to –0.553
Hct (%)16.9 ± 2.7319.5 ± 3.320.002–4.232 to –0.971
Retic (%)9.13 ± 2.397.38 ± 1.930.00050.769 to 2.732
S.Bil (mg/dL)4.63 ± 1.543.52 ± 1.930.0220.165 to 2.051
LDH (IU/L)967.5 ± 258.9793.2 ± 269.30.01040.692 to 208.317

Cl nohematologic, and transfusion characteristics of study patients with IgA-associated and non-IgA-associated WAIHA (N = 214)

CharacteristicsIgA-associated WAIHA (N = 17)*Non-IgA-associated WAIHA (N = 197)*p
Clinical characteristics
Age in years (range)50 (27–68)43 (20–71)
Sex (male:female)1:1.41:1.70.736
Primary WAIHA6 (35.3)81 (41.1)0.639
Secondary WAIHA11 (64.7)116 (58.9)
Lymphoproliferative disease6 (35.3)67 (34.1)
Systemic lupus erythematosus3 (17.6)22 (11.2)
Rheumatoid arthritis1 (5.9)14 (7.1)
Autoimmune hepatitis1 (5.9)4 (2)
Glomerulonephritis05 (2.5)
Thyrotoxicosis02 (1)
Polyarthritis nodosa01 (0.5)
Sarcoidosis01 (0.5)
Fever5 (29.4)34 (17.2)0.213
Jaundice4 (23.5)33 (16.7)0.478
Organomegaly7(41.2)71 (36)0.672
Palpitation10 (58.8)102 (51.8)0.576
Dyspnea7(41.2)65 (33)0.493
Immunohematologic characteristics
DAT positive17 (100)197 (100)
      DAT <2 +0 (0)61 (31)0.0067
      DAT ≥2+17 (100)136 (69)
DAT strength4+ (1+ to 4+)3+ (1+ to 4+)
IAT positive15 (88.2%)128 (65%)
      IAT <2+0 (0)48 (37.5)0.0036
      IAT ≥2+15 (100)80 (62.5)
IAT strength4+ (1+ to 4+)2+ (1+ to 4+)
Autocontrol strength3+ (1+ to 4+)2+ (1+ to 4+)
Blood group discrepancy1 (5.9)9 (4.6)0.805
Patients with new alloantibody1 (5.9)14 (7.1)0.849
Blood transfusion characteristics
Patients transfused (N)15 (88.2)86 (43.7)0.0004
PRBC units crossmatched (N)118309
PRBC units transfused (N)32123
Compatible PRBC units transfused5 (15.6)99 (80.5)0.983
“Least incompatible” PRBC units transfused27 (84.4)24 (19.5)
PRBC units transfused per patient (mean ± SD)2.13 ± 0.921.43 ± 0.68
Transfusion reaction2 (11.8)15 (7.6)0.543
History of previous transfusion11 (64.7)107 (54.3)0.408

Demographic, laboratory, and immunohematologic characteristics of study patients with IgA-associated WAIHA (N = 17)

Patient no.DemographicsLaboratory valuesImmunohematologic detailsTransfusion (PRBC units)
Age (years)SexHb (g/dL)Retic (%)S.Bil (mg/dL)LDH (IU/L)DAT (poly)DAT (mono)IAT
168M6.75.53.47984+IgG+IgA3+1
253M7.152.86543+IgG+IgA2+None
355F5.96.13.98804+IgG+IgA3+2
443F4.89.55.111024+IgA02
552F3.512.67.213494+IgG+IgA+C34+3
650F5.98.24.19014+IgG+IgA4+2
739F5.57.948734+IgG+IgA4+2
837M6.46.63.39953+IgG+IgA3+2
960M7.35.13.17093+IgG+IgA2+None
1051F4.610.27.315124+IgA03
1129F5.17.85.18934+IgG+IgA3+2
1259M3.913.46.913344+IgG+IgA+C34+3
1341F5.77.74.59214+IgG+IgA4+2
1435M6.26.846054+IgG+IgA3+1
1527F5.58.13.78194+IgG+IgA4+2
1657M5.883.48434+IgG+IgA3+2
1741F4.49.8712604+IgG+IgA+C34+3
DOI: https://doi.org/10.21307/immunohematology-2022-047 | Journal eISSN: 1930-3955 | Journal ISSN: 0894-203X
Language: English
Page range: 82 - 89
Published on: Sep 22, 2022
Published by: American National Red Cross
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2022 S.S. Das, S. Mukherjee, A. Chakrapani, D. Bhattacharyya, published by American National Red Cross
This work is licensed under the Creative Commons Attribution 4.0 License.