Autoimmune Hemolytic Anemia and Thromboembolism

 2/02/13 (El Chami)

Question: Could a patient's autoimmune hemolytic anemia be a causative factor in an occurrence of DVT or other thromboembolic complication?

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Unique Identifier:21259433

PMID:11359664

Authors: Saif MW.

Institution: National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA. saifw@mail.nih.gov

Title: HIV-associated autoimmune hemolytic anemia: an update. [Review] [35 refs]

Source: AIDS Patient Care & Stds. 15(4):217-24, 2001 Apr.

Abstract: In addition to developing immunosuppression, opportunistic infections, and malignancies, patients infected with human immunodeficiency virus (HIV) also develop many hematologic disorders. Although cytopenias including thrombocytopenia, anemia, and leukopenia, and bone marrow dysplasia are the most common hematologic complications encountered in such patients, hemostatic abnormalities that predispose patients to thromboembolism have also been recognized. Anemia in HIV patients can be multifactorial but an increased incidence of autoimmune hemolytic anemia has been manifested by the increased incidence of positive Coombs' test reported in patients with acquired immune deficiency syndrome (AIDS). Overt hemolysis is a rare complication. This review article discusses the etiology, pathophysiology, clinical features, diagnosis, treatment, and complications of autoimmune hemolytic anemia (AIHA) associated with HIV infection. [References: 35]

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Unique Identifier:98203407

PMID:9542286

Authors: Saif MW. Morse EE. Greenberg BR.

Institution: University of Connecticut School of Medicine, USA.

Title: HIV-associated autoimmune hemolytic anemia complicated by pulmonary embolism following a red blood cell transfusion: case report and review of the literature.

Source: Connecticut Medicine. 62(2):67-70, 1998 Feb.

Abstract: BACKGROUND: Though positive direct antiglobulin tests are common in AIDS patients, overt hemolysis is rare. A hypercoagulable state has recently been recognized in these patients and may contribute to the thromboembotic complications previously reported in three patients with HIV-associated autoimmune hemolytic anemia. CASE REPORT: An AIDS patient with severe warm autoimmune hemolytic anemia developed a pulmonary embolus after a single red blood cell transfusion. CONCLUSION: There may be an increased risk of thromboembolism in AIDS patients with autoimmune hemolytic anemia who receive red blood cell transfusions, a concern we have previously raised. Prophylactic anticoagulation should be considered in this setting.

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Unique Identifier:98057368

PMID:9396661

Authors: Winkelstein A. Kiss JE.

Title: Immunohematologic disorders. [Review] [113 refs]

Source: JAMA. 278(22):1982-92, 1997 Dec 10.

Abstract: Immunohematology encompasses a broad array of clinical disorders in which immune reactions are involved in the pathogenesis of hematologic diseases. Immune reactions can involve the formed elements of the blood, producing hemolytic anemia, thrombocytopenia, or neutropenia. Autoimmune phenomena and drug-induced reactions are the most common mechanisms. In newborns, maternal antibodies can cross the placenta and destroy red blood cells, platelets, or neutrophils. Immune reactions can also occur during transfusion of blood products, leading to hemolysis, febrile reactions, allergic reactions, and lung injury. The role of leukocytes and cytokines released during blood component storage in mediating febrile transfusion reactions has prompted the increased use of leukocyte-reduced components. Immune reactions can occur to soluble clotting factors and can produce bleeding or thrombosis. Finally, immunohematologic features of B-cell disorders are considered. [References: 113]