Day #161 - Autoimmune Haemolytic Anemia

The last morning report @ TGH. I move to MSH in January.

Today we heard a case of auto-immune haemolytic anemia presenting as symptomatic anemia. The patient may have had a prodromal illness.

This is a great article on AIHA. This one is good too.

In reading these something interesting became clear -- in what appears to be AIHA with a negative DAT there are a few possibilities.

• Subthreshold antibody (below the level of detection with DAT) -- this may be mitigated using a different method of DAT
  
• hereditary spherocytosis
• clostridial sepsis
  
• Two interesting ones include wilson's disease and Zieve's syndrome.

NB: AIHA with ITP (either together or sequentially) = Evan's Syndrome