[Clinical aspects of autoimmune hemolytic anemias]

In a retrospective examination are evaluated the clinical, haematologic and immunohematologic findings as well as the courses of the disease of 119 patients with autoimmunohemolytic anaemia (AIHA), i.e. 113 AIHA by thermic autoantibodies (-wa) and 6 AIHA (-co), consequently, AIHA-wa were observed 19 times more frequently than AIHA-co. Symptomatic AIHA-wa appear somewhat more frequently than idiopathic forms (60:53). The serum iron values are in most cases within or near the normal region in idiopathic as well as in symptomatic AIHA-wa. In 75% of the patients with idiopathic AIHA-wa a remission of the haemolysis could be achieved by a glucocorticoid treatment. A primary immunosuppressive combination therapy (glucocorticoids + azathioprine) was successful in all 8 patients. In one third of the patients the AIHA-wa could be cured, on the one hand, after one year the lethality was 33% (Dacie 1963 still 46%). The indication for splenectomy is discussed, since by means of this third therapy possibility a favourable influence of the course could be achieved in half of the 22 patients with symptomatic and idiopathic AIHA-wa. The importance of the thromboembolic complications is to be confirmed. So pulmonary embolisms are the most frequent cause of death in the 53 patients with idiopathic AIHA-wa. The concentration of the patients with AIHA in haematologic centres proved to be advantageous for these patients.