Felis ISSN 2398-2950

Anemia: immune-mediated hemolytic

Synonym(s): Autoimmune hemolytic anemia, AIHA

Contributor(s): Yvonne McGrotty

Introduction

  • Very rare in the cat.
  • Signs: pallor, lethargy.
  • Cause: antibody-mediated destruction of red cells by intravascular or extravascular hemolysis.
  • May be secondary to infection with FeLV and/or Haemoplasmas (feline infectious anemia).
  • Primary AIHA is much less common in the cat than in the dog.
  • Diagnosis: hematology, Coombs' test.
  • Treatment: treat underlying disease +/- immunosuppressive therapy.
  • Prognosis: guarded.

Pathogenesis

Etiology

  • Antibodies specific for erythrocyte membrane antigens, for absorbed drugs or infectious agents (Mycoplasma haemofelis) or for membrane antigens modified or exposed by the binding of such agents.
  • Antibodies specific for blood group antigens in incompatible blood transfusion Blood transfusion.
  • Antibodies (IgG or IgM), may fix complement and cause red cell removal by intravascular hemolysis or phagocytosis in spleen and liver (extravascular hemolysis).

Predisposing factors

General

Pathophysiology

  • Increased red cell breakdown results in hyperbilirubinemia →  jaundice if bilirubin formation exceeds conjugating capacity of the liver. Jaundice more common with extravascular hemolysis.
  • Intravascular hemolysis (less common), may lead to hemoglobinemia, hemoglobinuria.
  • Pathogenesis of anemia induced by FeLV Feline leukemia virus disease, may be complex, with immune-mediated hemolysis only one part, present in only a minority of anemic FeLV-infected cats.

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.
  • Kohn B, Weingart C, Eckmann V et al (2006) Primary immune-mediated hemolytic anemia in 19 cats: diagnosis, therapy, and outcome (1998-2004). J Vet Intern Med 20 (1), 159-166 PubMed.
  • Eibert M & Lewis D C (1997) Evaluation of the feline erythron in health and disease. Compendium on Continuing Education for the Practicing Veterinarian 19 (3), 335-347 VetMedResource.

Other sources of information

  • Raskin R E (2010) Haematologic Disorder. In: Clincial Medicine of the Dog and Cat.2nd edn. Schaer M (ed), Manson Publishing Ltd, London, pp 227-233.
  • Mackin A (2000) Immune-mediated haemolytic anaemia. In: Manual of Canine and Feline Haematology and Transfusion Medicine. 1st edn. Day M J, Mackin A & Littlewood J D (eds), BSAVA Publications, Gloucester, pp 67-77.
  • Giger U (1997) Feline hemolytic anemias. Proceedings of North American Veterinary Conference.


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