Autoimmune Hemolytic Anemia in Children: Clinical Profile and Outcome
Hemolytic Anemia in Children
DOI:
https://doi.org/10.54393/pjhs.v6i1.2581Keywords:
Autoimmune Hemolytic Anemia, Pediatric Patients, Treatment ResponsesAbstract
Autoimmune Hemolytic Anemia (AIHA) is an idiopathic condition marked by red blood cell destruction. Objective: To compare the clinical features, laboratory parameters, treatment approaches, and responses between idiopathic and secondary AIHA in pediatric patients, with the aim of identifying key distinctions that can inform the development of tailored diagnostic and therapeutic strategies. Methods: This was cross sectional study and conducted for six months from April 2024 to September 2024 at Department of pediatrics at Khairpur medical college khairpur mirs. Data were collected on demographics, presenting symptoms, laboratory findings (hemoglobin, bilirubin, LDH levels), antibody profiles, and treatment outcomes. SPSS 23 was used for statistical analysis to compare treatment responses and clinical characteristics between idiopathic and secondary AIHA patients. Chi-square tests were used for categorical variables and t-tests for continuous variables. Results: The mean age of participants was 6.8 years, with 58% male. Patients with idiopathic AIHA had higher hemoglobin levels (7.5 g/dL versus 6.9 g/dL for secondary, p=0.03) and lower bilirubin (3.6 mg/dL versus 4.1 mg/dL, p=0.02). Treatment varied significantly: 89% of idiopathic patients received steroids compared to 86% of secondary patients. Secondary patients were more likely to receive IVIG (51% versus 34%, p=0.04) and rituximab (37% versus 11%, p<0.01). Complete response rates were higher in idiopathic AIHA (83% versus 63%, p=0.01). Conclusions: Significant differences exist in the clinical presentation and treatment responses of idiopathic versus secondary AIHA. Tailored treatment strategies on AIHA type are essential for improving patient outcomes, warranting further research into these distinctions and new therapies.
References
Jäger U, Barcellini W, Broome CM, Gertz MA, Hill A, Hill QA et al. Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting. Blood Reviews. 2020 May; 41: 100648. doi: 10.1016/j.blre.2019.100648. DOI: https://doi.org/10.1016/j.blre.2019.100648
Fattizzo B and Barcellini W. Autoimmune hemolytic anemia: causes and consequences. Expert Review of Clinical Immunology. 2022 Jul; 18(7): 731-45. doi: 10.1080/1744666X.2022.2089115. DOI: https://doi.org/10.1080/1744666X.2022.2089115
Barcellini W and Fattizzo B. The changing landscape of autoimmune hemolytic anemia. Frontiers in Immunology. 2020 Jun; 11: 946. doi: 10.3389/fimmu.2020.00946. DOI: https://doi.org/10.3389/fimmu.2020.00946
Berentsen S, Frederiksen H, Fattizzo B. Autoimmune hemolytic anemia. The Rose and Mackay Textbook of Autoimmune Diseases. 2024 Jan: 427-47. doi: 10.1016/B978-0-443-23947-2.00024-2. DOI: https://doi.org/10.1016/B978-0-443-23947-2.00024-2
Xiao Z and Murakhoversuskaya I. Development of new drugs for autoimmune hemolytic anemia. Pharmaceutics. 2022 May; 14(5): 1035. doi: 10.3390/pharmaceutics14051035. DOI: https://doi.org/10.3390/pharmaceutics14051035
Yulistiani Y, Dwiyatna S, Utomo FN. Mechanism of Actions, Efficacy, and Long-term Use of Steroids in Autoimmune Hemolytic Anemia (AIHA). Molecular and Cellular Biomedical Sciences. 2023 Nov; 7(3): 109-21. doi: 10.21705/mcbs.v7i3.345. DOI: https://doi.org/10.21705/mcbs.v7i3.345
Loriamini M, Cserti-Gazdewich C, Branch DR. Autoimmune Hemolytic Anemias: Classifications, Pathophysiology, Diagnoses and Management. International Journal of Molecular Sciences. 2024 Apr; 25(8): 4296. doi: 10.3390/ijms25084296. DOI: https://doi.org/10.3390/ijms25084296
Paul V, Ittoop AL, Prakash A. Autoimmune hemolytic anemia in children: clinical profile and outcomes. Journal of Applied Hematology. 2021 Oct; 12(4): 232-5. doi: 10.4103/joah.joah_235_20. DOI: https://doi.org/10.4103/joah.joah_235_20
Cvetković Z, Pantić N, Cvetković M, Virijević M, Sabljić N, Marinković G et al. The Role of the Spleen and the Place of Splenectomy in Autoimmune Hemolytic Anemia-A Review of Current Knowledge. Diagnostics. 2023 Sep; 13(18): 2891. doi: 10.3390/diagnostics13182891. DOI: https://doi.org/10.3390/diagnostics13182891
Kumar S, Kaushik D, Sharma SK. Autoimmune Disorders: Types, Symptoms, and Risk Factors. Artificial Intelligence and Autoimmune Diseases: Applications in the Diagnosis, Prognosis, and Therapeutics. 2024 Feb: 3-1. doi: 10.1007/978-981-99-9029-0_1. DOI: https://doi.org/10.1007/978-981-99-9029-0_1
Tschachler E. Characterization of patients with monkeypox in Spain. 2022 Nov; 187(5): 765-772. doi: 10.1111/bjd.21790. DOI: https://doi.org/10.1111/bjd.21790
Chandra D, Capoor V, Maitri A, Naithani R. Autoimmune Hemolytic Anemia in Children. Pediatric Hematology Oncology Journal. 2024 Aug. doi: 10.1080/08880010701360783. DOI: https://doi.org/10.1016/j.phoj.2024.08.002
Voulgaridou A and Kalfa TA. Autoimmune hemolytic anemia in the pediatric setting. Journal of Clinical Medicine. 2021 Jan; 10(2): 216. doi: 10.3390/jcm10020216. DOI: https://doi.org/10.3390/jcm10020216
Gabelli M, Ademokun C, Cooper N, Amrolia PI. Pathogenesis, risk factors and therapeutic options for autoimmune haemolytic anaemia in the post‐transplant setting. British Journal of Haematology. 2022 Jan; 196(1): 45-62. doi: 10.1111/bjh.17648. DOI: https://doi.org/10.1111/bjh.17648
Blackall D and Dolatshahi L. Autoimmune hemolytic anemia in children: laboratory investigation, disease associations, and treatment strategies. Journal of Pediatric Hematology/Oncology. 2022 Apr; 44(3): 71-8. doi: 10.1097/MPH.0000000000002438. DOI: https://doi.org/10.1097/MPH.0000000000002438
Weli M, Hlima AB, Belhadj R, Maalej B, Elleuch A, Mekki N et al. Diagnosis and management of autoimmune hemolytic anemia in children. Transfusion Clinique et Biologique. 2020 Apr; 27(2): 61-4. doi: 10.1016/j.tracli.2020.03.003. DOI: https://doi.org/10.1016/j.tracli.2020.03.003
Arora S, Dua S, Radhakrishnan N, Singh S, Madan J, Nath D. Autoimmune hemolytic anemia in children: Clinical presentation and treatment outcome. Asian Journal of Transfusion Science. 2021 Jul; 15(2): 160-5. doi: 10.4103/ajts.AJTS_31_20. DOI: https://doi.org/10.4103/ajts.AJTS_31_20
Delesderrier E, Curioni C, Omena J, Macedo CR, Cople-Rodrigues C, Citelli M. Antioxidant nutrients and hemolysis in sickle cell disease. Clinica Chimica Acta. 2020 Nov; 510: 381-90. doi: 10.1016/j.cca.2020.07.020. DOI: https://doi.org/10.1016/j.cca.2020.07.020
Dei Zotti F, Qiu A, D'Agati VD, Jagnarine S, Kyritsis E, Miller A et al. Mitigation of checkpoint inhibitor-induced autoimmune hemolytic anemia through modulation of purinergic signaling. Blood. 2024 Oct; 144(15): 1581-94. doi: 10.1182/blood.2024024230. DOI: https://doi.org/10.1182/blood.2024024230
Michalak SS, Olewicz-Gawlik A, Rupa-Matysek J, Wolny-Rokicka E, Nowakowska E, Gil L. Autoimmune hemolytic anemia: current knowledge and perspectives. Immunity & Ageing. 2020 Dec; 17: 1-6. doi: 10.1186/s12979-020-00208-7. DOI: https://doi.org/10.1186/s12979-020-00208-7
Mueller L, Abunafeesa H, Fernandez DC, Kuriakose P. Primary versus secondary autoimmune hemolytic anemia: a retrospective analysis of diagnostic patterns and treatment outcomes. Blood. 2018 Nov; 132: 4881. doi: 10.1182/blood-2018-99-113208. DOI: https://doi.org/10.1182/blood-2018-99-113208
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