The purpose of this study was to review the clinical hematological, immunological features and treatment responsiveness in children with autoimmune hemolytic anemia (AHA). Eight children with AHA and positive Coombs' test was evaluated. Seven patients presented with acute onset of symptoms and histories of infection. One case was diagnosed as Evans syndrome, one as a chromosomal anomaly, and one case was combined with the Guillain-Barre syndrome. Among 8 the patients, 4 exhibited warm antibodies and the remainder had cold antibodies. The patients were given washed packed red blood cells, prednisolone or immunosuppressive drugs (6-MP or cyclophosphamide). Five patients responded well to transfusion and/or prednisolone, one patient died and one patient showed no response in 5 months of follow up.
Adolescent ; Anemia, Hemolytic, Autoimmune/blood ; Anemia, Hemolytic, Autoimmune/diagnosis* ; Anemia, Hemolytic, Autoimmune/therapy ; Child ; Child, Preschool ; Coombs' Test ; Female ; Human ; Infant ; Male ; Retrospective Studies

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

OBJECTIVE: To analyze the causes of positive irregular antibody screening test and incompatibility of cross matching in one patient with autoimmune hemolytic anemia complicated with neonatal hemolytic disease, and to accurately identify the type of antibodies in patients, and to select a reasonable strategy for blood transfusion. METHODS: One children was enrolled, blood group positive and reverse typing, Rh typing, direct anti-human globulin test, free test, dispersal test and cross matching test were carried out by test tube method and microcolumn gel card; irregular antibodies were identified by the reaction of DTT treatment and untreated panel cells with patients' plasma. RESULTS: The blood group of the patient was RhD positive B and irregular antibody screening positive, while the blood group of the mother was RhD positive O and irregular anti-screening negative, the result showed that the anti-LW detected in the plasma of the patient was autoantibody and ABO neonatal hemolytic disease (ABO-HDN) was present. Both O type RhD positive washing RBCs and B type RhD negative RBCs were transfused effectively. CONCLUSION Irregular antibodies in patients are anti-LW antibodies, and transfusion of homotype RhD negative suspended erythrocytes after the exclusion of ABO-HDN shows a better effect.
Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythroblastosis, Fetal ; Humans

In order to screen the compatible red cells by using extracorporal hemolysis test for acute autoimmune hemolytic anemia (AIHA) patients who were difficult to be matched by automatic microcolumn gel indirect antiglobulin test. Twenty-six cases of AIHA were chosen as control group, to whom the same type of donor red blood cells were infused with the weakest blood agglutination; 12 cases of acute AIHA patients were chosen as test group, these patients were difficult to be matched by automatic microcolumn gel indirect antiglobulin test, and the donor red cells without hemolysis by extracoral hemolysis test were transfused for them. The results showed that compared with the control group,the effect of transfusion was better in test group (P < 0.01), with 2.26 U leukocyte-depleted erythrocyte suspension in average, whose hemoglobin, reticulocyte and total bilirubin levels were changed significantly compared with those before blood transfusion (P < 0.01) . It is concluded that the compatible red blood cells for the acute AIHA patients can be screened by the extracorporal hemolysis test, when it is difficult to screen by the automatic microcolumn gel indirect antiglobulin test.
Anemia, Hemolytic, Autoimmune ; therapy ; Blood Transfusion ; Coombs Test ; Erythrocyte Count ; Erythrocytes ; Hemolysis ; Humans ; Platelet Transfusion

OBJECTIVE: To investigate the correlation of IgG subclasses with blood cell parameters in the patients with autoimmune hemolytic anemia (AIHA). METHODS: Thirty-four patients with AIHA (except C3d types) of immune complex type (IgG+C3d) and single IgG type, including 26 cases of primary AIHA and 8 cases of secondary AIHA from December 2010 to August 2016 in our hospital were selected and enrolled in AIHA group; 30 healthy persons were selected and enrolled in healthy control group. The levels of IgG subclasses in blood plasma were detected by double antibody sandwich ELISA in healthy persons and AIHA patients, at the same time. The levels of IgG subclasses in of RBC diffuse fluid were detected as well. The relation of IgG subclass level with some parameters of blood cells was analyzed in the hight of partial parameters of blood cells in patients. The independent sample test was used for comparison of data in 2 groups, the Spearman method was used for correlation analyziz. RESULTS: The average value of IgG1-4 in AIHA group was higher than that in healthy control group, there was statisticad difference between 2 groups (IgG1: t=-4.88, P<0.01; IgG2: t=-3.06. P<0.01; IgG3: t=-5.39, P<0.01; IgG4: t=-3.16, P<0.01), but the comparison of various. IgG subclass ratio in 2 groups showed that in addition to IgG4 (t=1.73, P >0.01) the ratio pf IgG1, IgG2 and IgG3 all had the statistical differences (IgG1: t=4.03, P<0.01; IgG2: t=7.38, P<0.01; IgG3: t=3.03, P<0.01). The spearmen analysis of corrclation of IgG subclass in blood plasma of patients with partial parameters of blood cells showed that the IgG4 positivety correlated with Hb level, the RBC count and HCT (Hb: r=0.358, P<0.05; RBC: r=0.426, P<0.05; HCT: r=0.363, P<0.05); the IgG1 and IgG2 negatively correlated with WBC count (IgG1: r=0.437, P<0.05; IgG2: r=-0.487, P<0.01); the IgG2 negatively correlated with count (r=-0.436, P<0.05). The comparison of IgG subclass ratio in plasma and RBC diffuse fluid of patients showed that in addition to IgG2 (t=1.544, P＞0.05), the rest IgG1, 3 and 4 all had statistical differences (IgG1: t=6.528, P<0.01; IgG3: t=-9.488, P<0.05; IgG4: t=-9.434, P<0.05). CONCLUSIONS The AIHA relates with IgG1 and IgG3, the detection of IgG subclasses may have a certain significance for studying the diagnosis, treatment and pothogenesis of AIHA.
Anemia, Hemolytic, Autoimmune ; Blood Cells ; Enzyme-Linked Immunosorbent Assay ; Erythrocyte Count ; Humans ; Immunoglobulin G

OBJECTIVE: To evaluate the efficacy and safety of different types of red blood cell (RBC) transfusion and hormone therapy in patients with autoimmune hemolytic anemia (AIHA). METHODS: The clinical data and serological characteristics of 40 patients with AIHA treated in our hospital from 2014 to 2018 were collected and analyzed retrospectively. The efficacy and safety of different type of RBC transfusion and hormone therapy were evaluated according to the principle of minimally incompatible RBC transfusion after cross-matching. RESULTS: Among 40 patients with AIHA, the female cases were more than the male cases, the cases of secondary AIHA was more than cases of primary AIHA, and the warm autoantibodies were in the majority. 11 cases of AIHA underwent 26 times minimally incompatible red blood cell transfusions. The total effective rate was 46.2%, the partial efficiency was 23.1%, and total inefficiency was 30.8%. Among them, the same type of non-washing red blood cell group showed efficiency of 42.1%, partial effective rate of 21.1%, and inefficiency of 36.8%; the same type of washed red blood cell group showed efficiency of 57.1%, partial effective rate of 28.6%, and inefficiency of 14.3%. the infusion effects was not significanly different between the two groups, and no hemolytic transfusion reaction occurred. In the hormone-treated group, the complete remission rate was 15.2%, the partial remission rate was 63.6%, and the ineffective rate was 21.2%. Among them, the side effects appeared in 2 patients after using hormones. CONCLUSION When AIHA patients need blood transfusion, use the same type of non-washed red blood cells or homologous washed cells is relatively safe, and the difference in efficacy is not significant. The partial remission of patients received hormone therapy is much higher than that of red blood cell transfusion, but the side effects easily happen.
Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Transfusion ; Erythrocyte Transfusion ; Erythrocytes ; Female ; Humans ; Male ; Retrospective Studies

OBJECTIVE: To evaluate the characteristics of autoimmune hemolytic anemia caused by salvianolate by antibody detection and clinical index monitoring. METHODS: Micro-column gel anti-human globulin method was used for irregular antibody screening and antibody identification. Salvianolate, sodium creatine phosphate and levocarnitine were used to sensitize red blood cells that were compatible with the patient's plasma, and the RBCs were used to test drug antibody in patient plasma respectively. The patient's clinical examination of hemolysis index and blood transfusion effect were analyed retrospectively. RESULTS: The patients were positive for irregular antibody screening, and there were antoanti-Ce antibodies in serum. The erythrocytes sensitized with salvianolate in the patient's serum were positive, while those sensitized with sodium creatine phosphate and levocarnitine were negative. CONCLUSION Salvianolate causes drug-induced autoimmune hemolytic anemia in this patient.
Anemia, Hemolytic, Autoimmune ; Blood Transfusion ; Erythrocytes ; Humans ; Plant Extracts ; Retrospective Studies

Autoimmune hemolytic anemia was diagnosed in a 60-year-old male without underlying disorder. He had complained of headache and exertional dyspnea. Laboratory studies revealed hemoglobin 4.9 g/dL, reticulocyte count 30%, total serum bilirubin 2.6 mg/dL, and haptoglobin 10 mg/dL. The peripheral blood smear showed marked spherocytosis. The bone marrow examination showed marked erythroid hyperplasia. The direct antiglobulin test was 2+ positive with anti-IgG and negative for C3d while indirect antiglobulin test was 1+ positive. The anti-E was identified in his serum and eluate from his red blood cells (RBCs). His blood group was group A, CcDEe. He had no transfusion history and autocontrol was positive. The adsorbed serum with ZZAP-treated RBCs did not react with a panel of reagent RBCs. These findings indicated that the antibody was autoanti-E. After transfusions of E-negative RBCs, the hemoglobin increased to 8.4 g/dL, and hemolytic transfusion reaction was not noted after transfusions. Treatment with prednisolone was effective in controlling the hemolytic anemia, but a splenectomy was performed to achieve permanent remission. After splenectomy the patient had normal hemoglobin and reticulocyte count lasting for three years without subsequent medical therapy.
Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Bilirubin ; Blood Group Incompatibility ; Bone Marrow Examination ; Coombs Test ; Dyspnea ; Erythrocytes ; Haptoglobins ; Headache ; Humans ; Hyperplasia ; Male ; Middle Aged ; Prednisolone ; Reticulocyte Count ; Splenectomy

The cryopathic hemolytic anemia is an autoimmune hemolytic anemia induced by cold antibody. Authors report a case of cryopathic hemolytic anemia confirmed by immunohematologic examination. A 22-year-old man was admitted at Kyung Hee Medical Center in March, 1994, with a past history of Kleinerfelter's syndrome and complained jaundice as well as dizziness. Direct antiglobulin test using polyvalent and anti-C3d monovalent antisera was positive, but was negative against anti-IgG, anti-IgA, and anti-IgM monovalent antisera. Cold agglutinin titer was as high as 1:1024 at 4 degrees C and anti-I specificity was confirmed by using cord bloods. The patient was not improved despite transfusion of washed red cells and administration of prednisolone, and on 16th day of hospitalization he manifested sudden episode of headache and loss of conscioussness, soon followed by death.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Coombs Test ; Dizziness ; Fetal Blood ; Headache ; Hospitalization ; Humans ; Immune Sera ; Jaundice ; Prednisolone ; Sensitivity and Specificity ; Young Adult