Abstract

Autoimmune haemolytic anaemia (AIHA) is a rare autoimmune disease characterised by haemolysis associated with the presence of immunoglobulins and/or components of the complement system on red blood cells (RBCs). It is classified into warm or cold antibody-mediated AIHA according to the temperature at which autoantibodies bind optimally to RBCs. Clinicians should be familiar with the procedural tests used for a complete laboratory investigation of AIHA. Good collaboration between clinicians and laboratory specialists with correct sample handling and an exact diagnostic work-up is extremely important for the correct classification and proper therapeutic management of AIHA. Specialised serological test procedures are very complex. Problems with serological testing may be excluded with the molecular testing, which has now become a gold standard to predict a patient’s phenotype in order to secure the right antigen-matched blood for AIHA patients. More recently, genotyping has been used instead of serological typing and complex adsorption tests. This paper offers a description of various tests for differentiating between types of AIHA. A diagnostic algorithm and the problems of laboratory investigation are also presented, and an application of molecular methods for the blood group typing in AIHA is elaborated.

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Authors

Mirela Raos - Clinical Department for Transfusion Medicine and Transplantation Biology, Clinical Hospital Center Zagreb, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia

Marija Lukic - Clinical Department for Transfusion Medicine and Transplantation Biology, Clinical Hospital Center Zagreb, Zagreb, Croatia

Drazen Pulanic - University of Zagreb, School of Medicine, Zagreb, Croatia; Division of Haematology, Department for Internal Diseases, Clinical Hospital Center Zagreb, Zagreb, Croatia; Medical Faculty Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia

Marijo Vodanovic - Division of Haematology, Department for Internal Diseases, Clinical Hospital Center Zagreb, Zagreb, Croatia

Branka Golubic Cepulic - Clinical Department for Transfusion Medicine and Transplantation Biology, Clinical Hospital Center Zagreb, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia; University of Split Department of Health Studies, Split, Croatia

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