Clinical features and prognostic factors of adult autoimmune hemolytic anemia

Objective: To explore the clinical characteristics and prognostic influencing factors of adult autoimmune hemolytic anemia (AIHA), improve clinicians' awareness of this disease and reduce the misdiagnosis rate. Methods: This study was a retrospective single-center research from 2018 to 2023. Clinical data from adult AIHA were analyzed. Results: Forty-one patients were enrolled, of whom were 10 males and 31 females, average age (54.4±15.9) years. The common clinical symptoms of AIHA were anemia (97.6%), dizziness or fatigue (92.7%), jaundice (85.4%), hepatosplenomegalgia (53.7%), soy colored urine (26.8%), melena (19.5%), fever (12.2%), abdominal pain or vomiting (4.9%). The hemolytic indexes of Lactate dehydrogenase (LDH) (95.1%), total bilirubin (TBIL) (85.4%), ferritin (free) (92.7%) and reticulocyte (Ret) (97.6%) are elevated. Nine patients were misdiagnosed, with 8 patients being misdiagnosed as gastrointestinal hemorrhage and 1 patient being misdiagnosed as acute cholecystitis. The risk factors for poor prognosis were revealed through a simple analysis of hemoglobin (HB), C-reactive protein (CRP), glutamic oxaltransaminase (AST), and secondary etiology. HB level and secondary etiology were independently identified as risk factors for poor prognosis by logistic regression analysis. Conclusion: The incidence of adult AIHA is low, and the clinical symptoms are complex and non-specific. HB level and secondary etiology were independent risk factors for poor prognosis. Coomb,s Positive is an important diagnostic method, and Coomb,s negative cannot be ruled out. It is important to be familiar with the clinical characteristics of adult AIHA, improve the understanding of AIHA, and avoid misdiagnosis and mistreatment .