Glossary of WAIHA

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What are 3 main categories of immune hemolytic anemias?
1. Alloantibody-induced
2. Autoantibody-induced
3. Drug-induced
What are the 2 types of alloantibody-induced HA?
1. Transfusion reaction
2. HDN
What are the 3 types of Autoantibody-induced HA?
1. Warm AIHA
2. Cold agglutinin disease
3. Paroxysmal Cold Hgburia
What is the cause of most cases of WAIHA?
What are some known causes of WAIHA?
Lymphoma, SLE, carcinoma.
What class of antibody causes WAIHA?
What are some common signs and symptoms of WAIHA?
Weak, dizzy, fever,
Spleno/hepatomegaly, lymphadenopathy.
What test is used for diagnosing autoimmune hemolytic anemias?
What are DAT results for WAIHA?
Polyspecific: 3-4+
Monospecific: 3-4+
Anti-C3: 0-3+
Control: 0
How do DAT results for WAIHA differ from CAD and PCH?
Those both show only complement components; WAIHA rarely is complement alone.
What needs to be determined when a patient has a positive DAT?
How is this done?
Rule out allo-antibody by doing an adsorption.
How do you decide what type of adsorption to perform?
-If not transfused in past 3-4 months, autoadsorption.
-If transfused, alloadsorption.
What is the principle of an autoadsorption?
-Patient RBCs + Patient serum to remove autoantibody.
-Test for alloantibody in the serum.
How do you determine how many adsorptions to do in order to test for an underlying allo- antibody?
Perform DAT, observe the serum reactivity; E.g., if IAT is 3+, then add 1 = 4 adsorptions.
How do you get Patient RBCs to be free of autoab in order to remove the Auto-Ab from serum?
By using ZZAP or enzymes to strip it from the antigens.
When is an allogeneic adsorption performed?
When the patient's phenotype is unknown.
What is the treatment for WAIHA?
Steroids - immunosuppressants

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