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IMMUNE HEMOLYTIC ANEMIAS

immunological destruction of red cells occurs when antibody

.and/or complement bind to red cell membrane

Classification of immune hemolytic

anemias

1. Autoimmune hemolytic anemia •

A-Warm antibody type – Primary or

idiopathic – Secondary: infections,

autoimmune disorders, lymphoma, chronic

lymphocytic leukemia
B-Cold antibody type – Cold agglutinin

disease – Paroxysmal cold hemoglobinuria

2.Alloimmune hemolytic anemia•

Hemolytic disease of newborn • Hemolytic

transfusion reaction

3. Drug-induced hemolytic anemia

 Warm antibody type autoimmune

hemolytic anemia occurs mainly in

persons over 50 years of age. Mild

jaundice and splenomegaly are common.

Red cells coated with IgG are recognized

by Fc receptors on macrophages and

 phagocytosed in spleen. In many cases,

phagocytosis is incomplete with

formation of spherocytes . Red cells

coated with IgG are detected by direct

antiglobulin test

Cold agglutinin disease

characterized by acrocyanosis (cyanosis of

fingers, toes, nose, and ears) due to the

presence of cold agglutinins that cause

agglutination of erythrocytes on exposure to

cold. The antibody is IgM, cold-reactive, and

after binding to red cells activates

complement. The disease usually occurs in

older individuals. Blood smear shows

autoagglutination of red cells .

 Blood smear in warm antibody type autoimmune hemolytic

anemia showing spherocytes, polychromasia, and late

normoblas
 .
(Blood smear in cold agglutinin disease showing large clusters of red
cells (autoagglutination(

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