Journal of Blood Disorders & Transfusion

Serological diagnosis and transfusion support in warm autoimmune hemolytic anemia

16^th World Hematology Congress

March 18-19, 2019 | Rome, Italy

Rajendra Chaudhary

Sanjay Gandhi Postgraduate Institute of Medical Sciences, India

Posters & Accepted Abstracts: Blood Disord Transfus

Abstract:

Serologic characterization of autoantibodies helps in the management of autoimmune hemolytic anemia (AIHA). Patients of AIHA frequently suffer severe anemia requiring blood transfusion which is a challenge. We have characterized the red cell bound autoantibodies in AIHA patients with regards to antibody class, subclass, DAT strength and their correlation with in vivo hemolysis. Detailed serological characterization was performed in 59 AIHA patients. Polyspecific (IgG +C3) DAT positive samples were tested for monospecific DAT (IgG, IgM, IgA, C3c, C3d) and IgG subclass (IgG1, IgG3). Thermal amplitude of autoantibodies was determined on eluates. In 55.8% of patients with AIHA was secondary to an underlying disorder. Patients with strong reactive DAT had increased likelihood of hemolysis (p=0.000). IgG was the solitary autoantibody coating the red cells in 72.1% of patients. Red cells coated with multiple immunoglobulins/complements and IgG subclass IgG1 and IgG3 were more susceptible to undergo hemolysis. Total of 24 patients received blood transfusion out of which four patients with highly reactive IAT (4+) and median autoantibody titer of 256 could only be issued least incompatible blood. Blood units whose strength of reactivity was less than the patient???s auto control strength were transfused to these four patients. All patients tolerated transfusion very well without any untoward effects. Despite failure to obtain compatible blood for some patients with AIHA, transfusion should not be withheld in critically ill patients. The least incompatible units can be transfused without any serious side effects. Specialized techniques such as elution and adsorption should be established in all transfusion services.

Biography :

E-mail: rkcsgpgi@gmail.com