BACKGROUND AND OBJECTIVES: Autoimmune hemolytic anemiA (AIHA) is rarely caused by IgM warm autoantibodies, and is sometimes difficult to diagnose. We describe three patients with severe AIHA caused by IgM warm autoantibodies; in two of the three, the hemolysis was fatal. MATERIALS AND METHODS: Conventional hematologic and serologic procedures were used. RESULTS: The IgM autoantibodies in all three cases were directed against determinants on or associated with glycophorin A (Ena, Wrb, and Pr). The IgM autoantibodies and unusual serological characteristics, in that the agglutinins were detected or greatly enhanced only by the presence of albumin or a low pH, and/or the agglutinins reacted optimally at 20-30 degrees C. CONCLUSIONS: IgM warm autoantibodies directed at determinants on or associated with glycophorin A appear to cause severe (often fatal) hemolytic anemia.
BACKGROUND AND OBJECTIVES:Autoimmune hemolytic anemiA (AIHA) is rarely caused by IgM warm autoantibodies, and is sometimes difficult to diagnose. We describe three patients with severe AIHA caused by IgM warm autoantibodies; in two of the three, the hemolysis was fatal. MATERIALS AND METHODS: Conventional hematologic and serologic procedures were used. RESULTS: The IgM autoantibodies in all three cases were directed against determinants on or associated with glycophorin A (Ena, Wrb, and Pr). The IgM autoantibodies and unusual serological characteristics, in that the agglutinins were detected or greatly enhanced only by the presence of albumin or a low pH, and/or the agglutinins reacted optimally at 20-30 degrees C. CONCLUSIONS: IgM warm autoantibodies directed at determinants on or associated with glycophorin A appear to cause severe (often fatal) hemolytic anemia.
Authors: Amr J Halawani; Mahmoud M Habibullah; Gasim Dobie; Alaa Alhazmi; Farkad Bantun; Mohammed H Nahari; Ibrahim Dawmary; Hisham I Abu-Tawil Journal: Int J Gen Med Date: 2021-12-03