Clinical and Experimental Medicine

, Volume 3, Issue 2, pp 55–64

Immune hemolysis-serological and clinical aspects

Authors

    • Institute for Transfusion MedicineUniversity Hospital Charité, Medical Faculty of the Humboldt-University of Berlin
  • A. Salama
    • Institute for Transfusion MedicineUniversity Hospital Charité, Medical Faculty of the Humboldt-University of Berlin
  • N. Ahrens
    • Institute for Transfusion MedicineUniversity Hospital Charité, Medical Faculty of the Humboldt-University of Berlin
  • A. Hansen
    • Outpatient DepartmentUniversity Hospital Charité
  • H. Kiesewetter
    • Institute for Transfusion MedicineUniversity Hospital Charité, Medical Faculty of the Humboldt-University of Berlin
  • J. Koscielny
    • Institute for Transfusion MedicineUniversity Hospital Charité, Medical Faculty of the Humboldt-University of Berlin
  • T. Dörner
    • Department of Rheumatology and Clinical ImmunologyUniversity Hospital Charité
REVIEW

DOI: 10.1007/s10238-003-0009-4

Cite this article as:
Pruss, A., Salama, A., Ahrens, N. et al. Clin Exp Med (2003) 3: 55. doi:10.1007/s10238-003-0009-4

Abstract.

The differential diagnosis of anemia must consider immune hemolytic anemias as a frequent cause. Whereas detection of anti-red blood cell (RBC) alloantibodies frequently induced by immunogenic stimuli (transfusion, pregnancy) is performed by routine serology, diagnosing autoimmune hemolytic anemias or drug-induced hemolytic anemias remains a challenge, usually requiring close collaboration of a number of disciplines. Positive direct antiglobulin test (Coombs’ test) represents a central criterion in diagnosing immune hemolytic anemias, leading to further detailed analyses. The most-severe type of immune-mediated hemolysis is acute intravascular hemolysis after ABO incompatible RBC transfusion. This review highlights underlying biochemical aspects, immunohematological diagnostics, and the clinical relevance of RBC allo- and autoantibodies, including paroxysmal nocturnal hemoglobinemia and drug-induced hemolysis. Finally, current and partly experimental therapeutic strategies of immune hemolytic anemias are summarized.

Key words

Transfusion reactionHemolytic anemiaImmune hemolysisBlood group systems

Copyright information

© Springer-Verlag Italia 2003