Nathalie Aladjidi1, Marthe-Aline Jutand2, Cyrielle Beaubois2,3, Helder Fernandes1, Julien Jeanpetit1, Gaelle Coureau2, Véronique Gilleron4, Aude Kostrzewa4, Pierre Lauroua5, Michel Jeanne5, Rodolphe Thiébaut6, Thierry Leblanc7, Guy Leverger8, Yves Perel1. 1. Pediatric Hematology Unit, Centre de Référence National des cytopénies auto-immunes de l'enfant (CEREVANCE), CIC 1401 INSERM CICP, University Hospital of Bordeaux, Bordeaux, France. 2. ISPED, University of Bordeaux, Bordeaux, France. 3. The Leucegene Preclinical Laboratory and Quebec Leukemia Cell Bank, Research Centre, Maisonneuve-Osemont Hospital, Montreal, Canada. 4. Service d'Information Médicale, Pôle de Santé Publique, University Hospital of Bordeaux, Bordeaux, France. 5. Aquitaine-Limousin Branch of the French Blood Institute, Bordeaux, France. 6. USMR and CIC-EC7, University Hospital of Bordeaux, Bordeaux, France. 7. Pediatric Hematology Unit, CEREVANCE, Robert Debré Hospital, APHP, Paris, France. 8. Pediatric Hematology Unit, CEREVANCE, Armand Trousseau Hospital, APHP, Paris, France.
Abstract
BACKGROUND: Childhood autoimmune hemolytic anemia (AIHA) is a rare and severe disease characterized by hemolysis and positive direct antiglobulin test (DAT). Few epidemiologic indicators are available for the pediatric population. The objective of our study was to reliably estimate the number of AIHA cases in the French Aquitaine region and the incidence of AIHA in patients under 18 years old. PROCEDURE: In this retrospective study, the capture-recapture method and log-linear model were used for the period 2000-2008 in the Aquitaine region from the following three data sources for the diagnosis of AIHA: the OBS'CEREVANCE database cohort, positive DAT collected from the regional blood bank database, and the French medico-economic information system. RESULTS: A list of 281 different patients was obtained after cross-matching the three databases; 44 AIHA cases were identified in the period 2000-2008; and the total number of cases was estimated to be 48 (95% confidence interval [CI]: 45-55). The calculated incidence of the disease was 0.81/100,000 children under 18 years old per year (95% CI 0.76-0.92). CONCLUSION: Accurate methods are required for estimating the incidence of AIHA in children. Capture-recapture analysis corrects underreporting and provides optimal completeness. This study highlights a possible under diagnosis of this potentially severe disease in various pediatric settings. AIHA incidence may now be compared with the incidences of other hematological diseases and used for clinical or research purposes.
BACKGROUND: Childhood autoimmune hemolytic anemia (AIHA) is a rare and severe disease characterized by hemolysis and positive direct antiglobulin test (DAT). Few epidemiologic indicators are available for the pediatric population. The objective of our study was to reliably estimate the number of AIHA cases in the French Aquitaine region and the incidence of AIHA in patients under 18 years old. PROCEDURE: In this retrospective study, the capture-recapture method and log-linear model were used for the period 2000-2008 in the Aquitaine region from the following three data sources for the diagnosis of AIHA: the OBS'CEREVANCE database cohort, positive DAT collected from the regional blood bank database, and the French medico-economic information system. RESULTS: A list of 281 different patients was obtained after cross-matching the three databases; 44 AIHA cases were identified in the period 2000-2008; and the total number of cases was estimated to be 48 (95% confidence interval [CI]: 45-55). The calculated incidence of the disease was 0.81/100,000 children under 18 years old per year (95% CI 0.76-0.92). CONCLUSION: Accurate methods are required for estimating the incidence of AIHA in children. Capture-recapture analysis corrects underreporting and provides optimal completeness. This study highlights a possible under diagnosis of this potentially severe disease in various pediatric settings. AIHA incidence may now be compared with the incidences of other hematological diseases and used for clinical or research purposes.
Authors: Robert T Galvin; Qing Cao; Weston P Miller; Jessica Knight-Perry; Angela R Smith; Christen L Ebens Journal: Transplant Cell Ther Date: 2021-01-20