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Autoimmune Hemolytic Anemias

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 385, Issue 15, Pages 1407-1419

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMra2033982

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AIHA is a group of diseases characterized by increased destruction of red cells through autoimmune mechanisms, and recent advancements in diagnosis and treatment have been made. Challenges include wider application of current knowledge, improved understanding of pathogenesis, development of new therapies, and management of refractory cases. Each individual disorder within the AIHA group should be addressed according to their unique differences in cause, pathogenesis, and clinical presentation.
AUTOIMMUNE HEMOLYTIC ANEMIA (AIHA) IS DEFINED AS INCREASED destruction of red cells through autoimmune mechanisms, usually mediated by autoantibodies against erythrocyte surface antigens. 13 During the past decade, important new findings have emerged regarding the cause, pathogenesis, diagnosis, and treatment of this group of disorders. Historically, clinical practice was based on theoretical considerations, case reports, and expert opinion, but more recently, several prospective and other systematic clinical studies have been conducted. The first international consensus on diagnosis and therapy was published in 2020,' and British guidelines have also been reported. 45 Challenges remain, however, including a wider application of current knowledge, an improved understanding of pathogenesis, development of new therapies, and management of refractory cases. AIHA is a common term for several diseases that differ from one another with respect to cause, pathogenesis, and clinical presentation, and the individual disorders should be addressed according to these differences (Table 1).

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