Course Outline
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- Immune Hemolytic Anemias
- Introduction
- Direct Antiglobulin Test (DAT)
- Classification of Hemolytic Anemias
- Alloimmune Hemolytic Anemia
- Alloimmune Hemolytic Anemia
- Autoimmune Hemolytic Anemias
- Autoimmune Hemolytic Anemia (AIHA): Introduction
- Symptoms of Autoimmune Hemolytic Anemias
- Testing for Autoantibodies
- Possible Serological and Laboratory Presentations
- True or False: A direct antiglobulin test (DAT) is usually negative in cases of autoimmune hemolytic anemia.
- Cold Autoimmune Hemolytic Anemia
- Cold Autoimmune Hemolytic Anemia
- Cold Hemagglutinin Disease (CHD)
- Paroxysmal Cold Hemoglobinuria (PCH)
- PCH Donath-Landsteiner Test
- ABO/Rh Typing in the Presence of Cold Autoantibodies
- Laboratory Presentations of Cold Autoantibodies - Antibody ID and Detection
- In paroxysmal cold hemoglobinuria (PCH), the autoantibody specificity is most commonly anti-I.
- Cold hemagglutinin disease (CHD) is caused by an IgM antibody with a broad thermal range.
- Warm Autoimmune Hemolytic Anemia
- Warm Autoimmune Hemolytic Anemia (WAIHA)
- Serological Characteristics in WAIHA
- WAIHA Investigation: Serological Findings Following Elution
- Possible Scenarios When Transfusions are Needed in the Presence of WAIHA
- Detection and Identification of An Alloantibody in the Presence of a Warm-Reactive Autoantibody
- Autologous Adsorption (Autoadsorption)
- Allogeneic Adsorption
- Transfusion Considerations for WAIHA
- Treatment of WAIHA
- In a case of WAIHA , the production of IgG or IgG and complement that sensitizes the red blood cells leads to red blood cell destruction.
- Which type of adsorption must be done if a patient has been recently transfused?
- Mixed-Type Autoimmune Hemolytic Anemia
- Mixed Type Autoimmune Hemolytic Anemia (AIHA)
- Drug-Induced Hemolytic Anemia
- Drug-Induced Immune Hemolytic Anemia Introduction
- Mechanisms
- Drug Adsorption Mechanism
- Immune Complex Mechanism
- Membrane Modification (Non-Immune Adsorption of Proteins)
- Induction of Autoimmunity
- Treatment of Drug-Induced Immune Hemolytic Anemia
- Laboratory Investigation of Drug-Induced Immune Hemolytic Anemia
- Which mechanism of drug-induced red cell destruction closely mimics the serologic presentation of warm autoimmune hemolytic anemia (WAIHA)?
- Which mechanism of drug-induced hemolytic anemia involves the formation of drug-antibody combinations that bind non-specifically to RBC membranes and ...
- Penicillin is one of the medications that may be responsible for the immune-complex mechanism of drug-induced hemolytic anemia.
- Case Study
- Case Study OneA 50-year-old female patient with systemic lupus erythematosus (SLE) is admitted to the hospital with evidence of hemolysis, including d...
- Case Study One, continued
- Case Study One, continued
- Case Study One, continued
- Case Study One, continuedTo determine the appropriate adsorption technique to use, an accurate transfusion history must be obtained. In this case the ...
- Case Study One, continued The results of the autoadsorbed serum tested with a set of antibody screen cells are shown on the right. What does the patte...
- Case Study One Conclusion
- Case Study
- Case Study Two
- Case Study Two, continued
- Case Study Two, continuedA DAT is ordered on the patient along with an antibody screen. The DAT is positive and the antibody screen is negative. Eluti...
- Case Study Two, Conclusion
- References
Additional Information
Author information: Erin Tretter, MBA, MT(ASCP), is currently the Rapid Response Laboratory Supervisor at Paoli Hospital. Erin received her Masters in Business Administration from Florida Institute of Technology where she is a member of the Phi Kappa Phi Honor’s Society. She received her BS in Medical Technology from California University of Pennsylvania and has experience as a Generalist, including Blood Bank, Hematology and Chemistry. Erin is currently the Blood Bank Clinical Instructor for the Clinical Laboratory Science Program at St. Christopher’s Hospital for Children and has 7 years experience teaching immunohematology concepts and laboratory procedures to laboratory science students. She has also taught Blood Bank in the Clinical Laboratory Technician program at the Community College of Philadelphia.
Reviewer information: Kathy W. Jones, MS, MLS(ASCP)CM is currently an Associate Professor in the Medical Laboratory Science Program at Auburn University Montgomery where she is responsible for the program courses in Clinical Hematology and Clinical Immunology. She holds a BS degree in Biology as well as a Master’s degree in Adult Education from Troy University. She received her Medical Laboratory Science certificate from St. Margaret’s Hospital School of Medical Technology and will celebrate her 40th year in Laboratory Science this year. Before she became a full-time educator she served in various roles in the clinical laboratory which included five years as a Hematology Supervisor.