AIHA

Question 1

Tests

Answer 1

DAT, antibody ID

Test to search for additional clinically significant, unexpected antibodies

Question 2

Cold Hemagglutinin Disease

Answer 2

Pathological cold auto antibodies 
Tend to have a high titer
Broad thermal range of reactivity 
Anti-I, enhanced with enzyme treated cells
Compliment activator IgM

Question 3

Warm AIHA

Answer 3

Most common AIHA
Moderate to severe hemolytic anemia 
Frequent hemolysis has an acute onset 
May ativate complement 
Do not ID

Question 4

Transfusion for WAIHA

Answer 4

Not recommended
Must use least incompatible blood
Transfused with small volumes
Phenotypically similar

Question 5

Drug Dependent Antibodies with Drug Coated Red Cells

Answer 5

Drug adsorption method
High dose IV Penicillin, Cephalosporins
IgG, may have C'
DAT is strong positive 
Reactive with drug coated cells only 
Gradual hemolysis, extravascular

Question 6

Other Drug depended Antibodies

Answer 6

Immune complex
Quinidine and Phenacetin 
IgG or IgM
C' may be only globulin 
Non-reactive eluate, positive with drug coated cells
Acute intravascular hemolysis

Question 7

Drug Independent Antibodies

Answer 7

Autoantibody production
a-methyldopa, L-dopa, aldomet
IgG
DAT IgG strongly positive 
Eluate positive with all cells tested 
Acute onset, severe

Question 8

Nonimmunologic Protein Adsorption

Answer 8

Membrane modification
Cephalosporins, Cephalothin (Keflin)
Many plasma proteins
DAT positive due to variety of serum proteins
Reacts with everything at AHG phase
No hemolysis, positive DAT and IAT