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The page below is a sample from the LabCE course Immune Hemolytic Anemias (retired 3/18/2020). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Warm Autoimmune Hemolytic Anemia (WAIHA)

WAIHA is the most common type of autoimmune hemolytic anemia. It is usually associated with warm reacting (37°C) IgG antibodies.
WAIHA may be idiopathic or secondary to a pathologic disorder (eg, systemic lupus erythematosus).
Clinical symptoms associated with WAIHA
If significant anemia is present, patients may exhibit pallor, weakness, dizziness, jaundice, dyspnea, and fever.
Possible laboratory findings
  • Positive direct antiglobulin test (DAT). It's important to obtain an adequate patient history, including previous transfusions and current medications to help establish the cause of the positive DAT.
  • Erythrocyte morphology abnormalities, as seen in the Wright-stained peripheral blood smear image on the right.
    • Polychromatophilic red cells(A--green arrows)
    • Spherocytes (B--blue arrows)
    • Schistocytes (C--red arrows)
    • Nucleated red blood cells (D-- orange arrow)