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Autoimmune Hemolytic Anemia in the Pediatric Age Group: The Egyptian Experience
Amina Abdel-Salam1, Sherifa Tarek Bassiouni2, Alaa Magdi Goher1
1Deparment of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
This study found that secondary autoimmune hemolytic anemia (AIHA) is more common in Egyptian children, particularly females. High-dose IV steroids effectively treated acute AIHA attacks in most pediatric patients.
Area of Science:
- Pediatric Hematology
- Immunology
- Clinical Medicine
Background:
- Autoimmune hemolytic anemia (AIHA) is rare in children, with limited existing literature.
- Understanding pediatric AIHA is crucial due to its distinct characteristics and potential severity.
Purpose of the Study:
- To determine the frequency of AIHA in Egyptian children.
- To describe the clinical and laboratory features of pediatric AIHA.
- To evaluate treatment outcomes for children with AIHA.
Main Methods:
- Retrospective analysis of 50 pediatric AIHA patients (2010-2021) at New Children's Hospital, Cairo.
- Data collection included demographics, hemoglobin levels, reticulocyte counts, Coombs test results, and treatment responses.
- Categorization into primary and secondary AIHA, with assessment of associated conditions like Evans syndrome.
Main Results:
- Secondary AIHA (60%) was more prevalent than primary AIHA (40%) in this cohort.
- AIHA was more common in females (60%) with a median age of 8.25 years.
- High-dose IV steroids achieved a positive response in 76% of patients with acute AIHA attacks.
Conclusions:
- Secondary AIHA is the predominant form in Egyptian children.
- Pediatric AIHA exhibits specific demographic and clinical patterns in Egypt.
- Intravenous steroid therapy is an effective first-line treatment for acute pediatric AIHA.
Abstract:
Autoimmune hemolytic anemia (AIHA) is a common disease entity among adults; however, it is rare among the pediatric age group. Evidence is scarce regarding pediatric AIHA in the literature. The objective of this study is to assess the frequency of AIHA and describe the clinical and laboratory characteristics and treatment outcomes of a cohort of children with AIHA in Egypt. A retrospective study was conducted on 50 children with AIHA who were registered and followed up at the New Children's Hospital in Cairo, Egypt, between January 2010 and January 2021. The study group comprised 60% females and 40% males. Their median age was 8.25 years. All patients showed low hemoglobin levels with a mean of 5.40 ± 1.34 g/dl and a median reticulocyte count of 10 (IQR: 8-15). Twelve (24%) patients were diagnosed with Evans syndrome, and a positive Coombs test was detected in 46 patients (92%). The frequency of primary AIHA was 40%, whereas it was 60% for secondary AIHA. The first line of therapy for acute attacks was high-dose IV steroids which responded well in 38 (76%) patients. Secondary AIHA was more common among our children (60%). AIHA is more prevalent in females (60%). The clinical and laboratory characteristics matched previous reports.
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