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Diagnosis is made by first ruling out other causes of hemolytic anemia, such as G6PD, thalassemia, sickle-cell disease. Clinical history is also important to elucidate any underlying illness or medications that may have led to the disease. [citation needed] Laboratory investigations are carried out to determine the etiology of the disease.
A positive direct antiglobulin test differentiates immune-mediated hemolytic anemia from a nonimmune-mediated cause. Other situations such as liver disease, post-transfusion or immunoglobulin administration, renal disease, and malignancy can cause a positive direct antiglobulin test. [1]
The work-up for diagnosis is complex and the condition can be over-diagnosed. [1] [2] [better source needed] People diagnosed with warm autoimmune hemolytic anemia (WAIHA) caused by immunoglobulin G (IgG) [3] may also have a high number of immunoglobulin M antibodies. These antibodies are active at room temperature, but are believed to be ...
Each sample is incubated against a wide range of RBCs that together exhibit a full range of surface antigens (i.e. blood types). Cross matching; The indirect Coombs test is used to test a sample of the recipient's serum for antibodies against a sample of the blood donor's RBCs. This is sometimes called cross-matching blood.
The most common antibody isotype involved in warm antibody AIHA is IgG, though sometimes IgA is found. The IgG antibodies attach to a red blood cell, leaving their F C portion exposed with maximal reactivity at 37 °C (versus cold antibody induced hemolytic anemia whose antibodies only bind red blood cells at low body temperatures, typically 28–31 °C).
Cold agglutinins develop in more than 60% of patients with infectious mononucleosis, but hemolytic anemia is rare. Classic chronic cold agglutinin disease is idiopathic, associated with symptoms and signs in relation to cold exposure.
Establish the diagnosis of autoimmune hemolytic anemia and differentiate from other AIHA. [18] [10] [19] Identify other supporting features as in hematopathological findings. [16] For intravascular hemolysis, the laboratory parameters include increased serum free hemoglobin, lactate dehydrogenase, unconjugated bilirubin, and reduced haptoglobin.
Conversely, these antibodies are absent in people who take statin medications but do not have myopathy. Thus, the presence of anti-HMG CoA reductase antibodies in someone who uses a statin and has myopathy strongly supports the diagnosis. [3] CK levels increase to 10-100 times above normal (2000–20,000 IU/L) in more than 90% of cases.