louis vuitton sneakers for men Advances in pathophysiology and treatment
Autoimmune hemolytic anemia due to warm antibodies (wAIHA) accounts for approximately 70% to 80% of all AIHAs in adults. The pathogenesis of wAIHA is a complex multistep process, the last step of which being the abnormal production of auto antibodies directed towards red blood cells’ membrane antigens. The recent advances in the understanding of the underlying mechanisms leading to the breakdown of self tolerance in wAIHA, mainly thanks to the study of animal models are discussed in this review. Treatment of wAIHA has long been empirical and mainly based on corticosteroids. In the last decade however, the efficacy of rituximab as second line treatment has been demonstrated first in retrospective and more recently throughout prospective studies. Based on these advances,
an algorithm for the management of primary adult’s wAIHA is proposed in this review. Immune haemolytic anemias PA:Churchill Livingstone(2004). The diagnosis of AIHA is thus based on the presence of a hemolytic anemia with a positive direct antiglobulin (or Coombs) test (DAT) and on the absence of any other hereditary of acquired cause of hemolysis [1MichelM. Immune haemolytic anemias PA:Churchill Livingstone(2004). wAIHA can be either primary (or idiopathic) or associated, in at least half of the cases, with or reveal an underlying disease and be therefore classified as “secondary” wAIHA [1MichelM.
The aim of this review is to provide an update on the recent advances on pathophysiology mostly extrapolated from animal models and also on the treatment of adult’s wAIHA taking into account some recent data from the very first prospective studies that have been recently reported. Warm autoimmune haemolytic anemia: recent progress in understanding the immunobiology and treatment Transfus Med Rev2010 ; 24 : 195 210.