Equis ISSN 2398-2977

Anemia: auto-immune hemolytic (AIHA)

Synonym(s): AIHA

Contributor(s): Cody Coyne, Mark Holmes, Prof Derek Knottenbelt

Introduction

  • Rare.
  • Cause: primary or secondary to drugs, eg penicillin (hapten phenomenon)    Penicillin G  , neoplasia      Gastrointestinal: neoplasia - melanoma  , viral or bacterial infections.
  • Signs: depend on underlying disease; non-specific malaise, pale mucous membranes, tachycardia.
  • Diagnosis: Coomb's test, bone marrow biopsy.
  • Treatment: blood transfusion   Blood: transfusion  , corticosteroids   Dexamethasone  , plasma phoresis.
  • Prognosis: depends on cause.

Pathogenesis

Predisposing factors

General
  • Recent drug administration (paten phenomenon).
  • Recent systemic bacterial or viral infection.
  • Equine infectious anemia   Equine infectious anemia (EIA)  .
  • Clostridum perfringens  Clostridia spp  infections   Gastrointestinal: clostridiosis  have been reported in association with AIHA in at least two cases.
  • Neoplastic conditions, especially lymphosarcoma    /mesothelioma.

Pathophysiology

  • Aberrant production of antibodies that bind surface antigens of red blood cells.
  • Antibody production is thought to occur in one of three ways:
    • The erythrocyte membrane is altered by systemic bacterial or viral infections or neoplastic disorders and antibody production is directed at this antigen perceived as 'foreign'.
    • Immunocompetent clones develop and direct their products at the red cell membrane.
    • Small molecules like pharmaceuticals bind to membrane associated antigens creating a hapten-facilitated immune reaction.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Peek S F (2010) Immune-mediated haemolytic anaemia in adult horses: Do we need to transfuse, immunosuppress or just treat the primary problem? Equine Vet Educ 22 (1), 20-22 VetMedResource.
  • Underwood C & Southwood L L (2008) Haemolytic anaemia as a complication following colic surgery in a 10-year-old Arabian stallion. Equine Vet Educ 20 (8), 422-426 VetMedResource.
  • McConnico R S, Roberts M C & Tompkins M (1992) Penicillin-induced immune-mediated hemolytic anemia in a horse. JAVMA 210 (9), 1402-1403 PubMed.
  • Beck D J (1990) A case of primary autoimmune hemolytic anemia in a pony. Equine Vet J 22 (4), 292-294 PubMed.
  • Morris D D (1989) Review of anemia in horses. Equine Pract 11, 34-46 VetMedResource.


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