Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders.
Cristiana BiancoElena ColuccioDaniele PratiLuca Vittorio ValentiPublished in: Journal of clinical medicine (2021)
Anemia is a common feature of liver and bowel diseases. Although the main causes of anemia in these conditions are represented by gastrointestinal bleeding and iron deficiency, autoimmune hemolytic anemia should be considered in the differential diagnosis. Due to the epidemiological association, autoimmune hemolytic anemia should particularly be suspected in patients affected by inflammatory and autoimmune diseases, such as autoimmune or acute viral hepatitis, primary biliary cholangitis, and inflammatory bowel disease. In the presence of biochemical indices of hemolysis, the direct antiglobulin test can detect the presence of warm or cold reacting antibodies, allowing for a prompt treatment. Drug-induced, immune-mediated hemolytic anemia should be ruled out. On the other hand, the choice of treatment should consider possible adverse events related to the underlying conditions. Given the adverse impact of anemia on clinical outcomes, maintaining a high clinical suspicion to reach a prompt diagnosis is the key to establishing an adequate treatment.
Keyphrases
- iron deficiency
- drug induced
- chronic kidney disease
- liver injury
- end stage renal disease
- multiple sclerosis
- newly diagnosed
- oxidative stress
- emergency department
- ejection fraction
- sars cov
- machine learning
- liver failure
- prognostic factors
- decision making
- hepatitis b virus
- peritoneal dialysis
- acute respiratory distress syndrome
- replacement therapy
- smoking cessation