Clinical and Experimental Medicine

, Volume 3, Issue 2, pp 55–64

Immune hemolysis-serological and clinical aspects

  • A. Pruss
  • A. Salama
  • N. Ahrens
  • A. Hansen
  • H. Kiesewetter
  • J. Koscielny
  • T. Dörner
REVIEW

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 reaction Hemolytic anemia Immune hemolysis Blood group systems 

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Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • A. Pruss
    • 1
  • A. Salama
    • 1
  • N. Ahrens
    • 1
  • A. Hansen
    • 2
  • H. Kiesewetter
    • 1
  • J. Koscielny
    • 1
  • T. Dörner
    • 3
  1. 1.Institute for Transfusion MedicineUniversity Hospital Charité, Medical Faculty of the Humboldt-University of BerlinBerlinGermany
  2. 2.Outpatient DepartmentUniversity Hospital CharitéBerlinGermany
  3. 3.Department of Rheumatology and Clinical ImmunologyUniversity Hospital CharitéBerlinGermany

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