Presentation Title

A Rare Cause of Childhood Anemia: Warm-reactive Autoimmune Hemolytic Anemia

Speaker Credentials

DO

Format

Poster

Start Date

6-11-2020 11:00 AM

End Date

6-11-2020 11:15 AM

Abstract

Introduction: Autoimmune hemolytic anemia (AIHA), is a rare cause of anemia in children, and is characterized by the presence of autoantibodies, which lead to premature destruction of red blood cells. AIHA is classified into primary or secondary based on the presence of an underlying illness. The majority of all pediatric cases is warm-type AIHA, accounting for about 40-50% pediatric AIHA cases, as illustrated in this case. Case Description: A healthy 23-month-old boy presenting with pallor and decreased activity. The patient had an abrupt onset of pallor and was found to be anemic with a low-grade fever. Past medical history was significant for roseola and hand-foot-mouth disease. On physical exam, the patient had pale mucous membranes, bilateral periorbital edema, tachycardia, bilateral cervical and inguinal lymphadenopathy. Laboratory studies showed a macrocytic anemia with a reticulocyte count 10.67%. The patient was diagnosed with idiopathic warm antibody positive autoimmune hemolytic anemia. The patient underwent treatment with IVIG, whole blood transfusion and solumedrol. The patient responded to treatment appropriately and was discharged home with oral corticosteroids. Discussion: This case illustrates a rare cause of pediatric anemia, warm-reactive autoimmune hemolytic anemia. This patient was successfully treated with corticosteroids, which is the most effective first-line treatment for warm AIHA. Corticosteroids inhibit Fc receptor mediated clearance of erythrocytes tagged with IgG in the spleen, which make them effective treatment in IgG type of warm AIHA. In this case, the child responded well to all treatments and was able to have a full remission with a course of corticosteroids.

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Nov 6th, 11:00 AM Nov 6th, 11:15 AM

A Rare Cause of Childhood Anemia: Warm-reactive Autoimmune Hemolytic Anemia

Introduction: Autoimmune hemolytic anemia (AIHA), is a rare cause of anemia in children, and is characterized by the presence of autoantibodies, which lead to premature destruction of red blood cells. AIHA is classified into primary or secondary based on the presence of an underlying illness. The majority of all pediatric cases is warm-type AIHA, accounting for about 40-50% pediatric AIHA cases, as illustrated in this case. Case Description: A healthy 23-month-old boy presenting with pallor and decreased activity. The patient had an abrupt onset of pallor and was found to be anemic with a low-grade fever. Past medical history was significant for roseola and hand-foot-mouth disease. On physical exam, the patient had pale mucous membranes, bilateral periorbital edema, tachycardia, bilateral cervical and inguinal lymphadenopathy. Laboratory studies showed a macrocytic anemia with a reticulocyte count 10.67%. The patient was diagnosed with idiopathic warm antibody positive autoimmune hemolytic anemia. The patient underwent treatment with IVIG, whole blood transfusion and solumedrol. The patient responded to treatment appropriately and was discharged home with oral corticosteroids. Discussion: This case illustrates a rare cause of pediatric anemia, warm-reactive autoimmune hemolytic anemia. This patient was successfully treated with corticosteroids, which is the most effective first-line treatment for warm AIHA. Corticosteroids inhibit Fc receptor mediated clearance of erythrocytes tagged with IgG in the spleen, which make them effective treatment in IgG type of warm AIHA. In this case, the child responded well to all treatments and was able to have a full remission with a course of corticosteroids.