[Autoimmune hemolytic anemia: Case review]

Area of Science:

• Pediatric Hematology
• Immunology
• Rare Diseases

Background:

• Autoimmune hemolytic anemia (AIHA) is a rare pediatric condition.
• It is typically self-limiting in children.

Purpose of the Study:

• To describe the clinical characteristics, treatment response, and outcomes of AIHA in children.
• To classify AIHA based on direct antiglobulin test (DAT) findings.

Main Methods:

• A descriptive cross-sectional study of children under 18 diagnosed with AIHA from 1997-2019.
• Classification of AIHA into warm (IgG+/-C3d) and cold (C3d) based on DAT.
• Analysis of clinical variables, treatment response, and disease evolution.

Main Results:

• 25 pediatric patients were analyzed; 72% were male, median age 2 years.
• Common symptoms included fever, pallor, jaundice; median hemoglobin was 5.4 g/dl.
• Most cases (96%) had a positive DAT, primarily IgG antibodies (76%). 72% responded to corticosteroids; 24% needed second-line treatments. Complications and relapses occurred in warm AIHA.

Conclusions:

• AIHA is a very rare childhood disease with predominantly favorable outcomes.
• Up to 25% of cases may require second-line or aggressive treatments.
• Patients with co-existing cytopenias are more likely to need intensive therapies.