Muhammad Farooq Khattak, Masood Anwar, Nadir Ali, Farhat Abbas Bhatti, Karamat Ahmed Karamat.
Spectrum and aetiology of Immune Haemolytic Anaemia in adults.
Pak Armed Forces Med J Jan ;49(2):99-102.

Study was conducted to find out the spectrum and aetiology of immune haemolytic anaemia in adults. Initial antibody screening was done by direct and indirect antiglobulin test. If antibody was detectable in initial screening nature and specificity of antibody were determined. In suspected patients of cold antibody type autoimmune haemolytic anaemia thermal range, biphasic nature of antibody and titre were determined. Thirty three cases of immune haemolytic anaemia were studied during one year period. Autoimmune haemolytic anaemia (AIHA) was detected in 26 patients. Fifteen patients were of warm AIHA, seven were male and eight were female. Cold type AIHA was detected in 8 patients, five were male and three were female. Three patients of mixed cold and warm AIHA were detected, two were male and one was female. Alloimmune haemolytic anaemia was detected in 7 patients. All the 7 patients were of Beta thalassaemia major on regular transfusions. Four were male and three were female. Aetiological factor was detectable in 9 out of 15 patients of warm AIHA. Two patients were of CLL, 3 with SLE, 3 with drug associated and I with thyroid disease. Pan reactive antibody was detected in 9 cases, antibodies in rest of the 6 cases were within Rh group. In case of cold AIHA one patient was of multiple myeloma and one had chicken pox. Aetiological factor was not detectable in rest of the 6 cases. Anti-I was detected in 5 cases, anti-i in one case and anti-P in 2 cases. In case of mixed AIHA, 2 were of SLE and one was with NHL. Alloantibodies were specified in all 7 cases of alloimmune haemolytic anaemia. Anti-c in 3 cases, anti-E, anti-K, anti-Le and anti-S in one case each. The problem is not uncommon in our patient population and elucidation of type specificity is of help in further management of these patients.

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