Mixed autoimmune hemolytic anemia
| Mixed autoimmune hemolytic anemia | |
|---|---|
| Synonyms | MAHA |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Fatigue, pallor, jaundice, dyspnea |
| Complications | Heart failure, kidney failure |
| Onset | Any age |
| Duration | Chronic |
| Types | N/A |
| Causes | Autoimmune disease |
| Risks | Systemic lupus erythematosus, rheumatoid arthritis, lymphoproliferative disorders |
| Diagnosis | Coombs test, blood smear, complete blood count |
| Differential diagnosis | Hereditary spherocytosis, G6PD deficiency, cold agglutinin disease |
| Prevention | N/A |
| Treatment | Corticosteroids, immunosuppressive drugs, rituximab, splenectomy |
| Medication | N/A |
| Prognosis | Variable, depends on underlying cause and response to treatment |
| Frequency | Rare |
| Deaths | N/A |
Mixed autoimmune hemolytic anemia (MAHA) is a rare type of anemia characterized by the destruction of red blood cells by the body's own immune system. This condition is a combination of both warm and cold autoimmune hemolytic anemia, hence the term "mixed".
Etiology
The exact cause of mixed autoimmune hemolytic anemia is unknown. However, it is often associated with other autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis, and chronic lymphocytic leukemia (CLL). It can also occur as a result of certain medications or infections.
Pathophysiology
In mixed autoimmune hemolytic anemia, the immune system produces antibodies that mistakenly target and destroy the body's own red blood cells. These antibodies can function at both warm (body temperature) and cold temperatures, leading to the destruction of red blood cells in both the central and peripheral circulation.
Clinical Presentation
Patients with mixed autoimmune hemolytic anemia may present with symptoms of anemia such as fatigue, pallor, shortness of breath, and rapid heart rate. They may also have symptoms related to the underlying autoimmune disease.
Diagnosis
Diagnosis of mixed autoimmune hemolytic anemia involves a series of blood tests including a complete blood count (CBC), direct antiglobulin test (DAT), and indirect antiglobulin test (IAT). The presence of both warm and cold autoantibodies is a key diagnostic feature of this condition.
Treatment
Treatment of mixed autoimmune hemolytic anemia is aimed at reducing the destruction of red blood cells and managing the underlying autoimmune disease. This may involve the use of corticosteroids, immunosuppressive drugs, and in severe cases, blood transfusion.
Prognosis
The prognosis of mixed autoimmune hemolytic anemia varies depending on the severity of the condition and the underlying autoimmune disease. With appropriate treatment, many patients can achieve a good quality of life.
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Contributors: Prab R. Tumpati, MD