Autoimmune Hemolytic Anemia: Current Concepts

Autoimmune hemolytic anemia (AIHA) is one end of a spectrum of clinical and serological disorders resulting from an autoimmune attack against red cells. Although the etiology of this disorder is far from firmly established, the pathogenesis of red cell destruction by the effector mechanisms of the immune system is well characterised and correlates well with the clinical and serological features of this disorder. Direct antiglobulin test (DAGT) negative AIHA, production crises, AIHA in children and following alpha methyldopa therapy are subgroups of AIHA which have recently been described or more clearly defined and understood. The addition of high dose immunoglobulin and danazol as well as the potential use of more novel approaches to the traditional triad of corticosteroids, splenectomy and immunosuppressive agents has expanded and increased the flexibility of the therapeutic options in this disorder.