Medical Importance

Immune hemolytic anemias can occur as isolated conditions or in association with a variety of systemic illnesses (particularly rheumatic conditions, infections, and various neoplasms), or can be induced by certain medications. These conditions can produce life-threatening anemia; prompt diagnosis and treatment are essential.

Objectives

1. Describe the pathophysiology and site of red blood cell destruction of immune-mediated hemolysis due to IgG, IgM, and complement.


2. Describe the procedures involved in performing a direct antiglobulin test (direct Coombs test) and an indirect antiglobulin test (indirect Coombs test).


3. List mechanisms by which drugs induce immune hemolytic anemia.


4. Distinguish warm antibody-induced autoimmune hemolytic anemia from cold antibody-induced autoimmune hemolytic anemia on the basis of:
   
   • Immunoglobulin class of the antibody
     
   • Presence of red blood cell agglutination
     
   • Direct antiglobulin test results
     
   • Clinical manifestations

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