title: Autoimmune hemolytic anemia in India: clinico-hematological spectrum of 79 cases.
abstract: The clinico-hematological profile and treatment outcome of patients with autoimmune hemolytic anemia (AIHA) were assessed using a retrospective case record analysis. There were 79 (52 primary; 27 secondary) consecutive patients identified with a median age of 30.5 years. The main presenting complaints were pallor (94%), fever (46%), jaundice (51%), bleeding manifestations (10%) and splenomegaly (68%). Jaundice was much more common in primary (63%) as opposed to secondary (26%) disease. The direct antiglobulin test was negative in six patients. Oral prednisolone produced remission in 87.5% patients. Six patients (three children, three adults) relapsed after a median period of 2 months after response. All of these responded to a second course of steroids, in a median period of 14 days. No correlation was found between response and the parameters of age, sex, jaundice, low pretreatment hemoglobin, reticulocyte count, total leucocyte count (TLC), platelet count, subtype of AIHA and hepatosplenomegaly. Relapse correlated with increased duration between the onset of symptoms and treatment (r = 0.996; p = 0.0001).
authors.affiliation: Department of Haematology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Naithani
authors.forename: Neerja
authors.initials: N
authors.lastname: Agrawal
authors.forename: M
authors.initials: M
authors.lastname: Mahapatra
authors.forename: H
authors.initials: H
authors.lastname: Pati
authors.forename: Rajat
authors.initials: R
authors.lastname: Kumar
authors.forename: V P
authors.initials: VP
authors.lastname: Choudhary
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007565:Jaundice / Q000097:blood / Q000178:diet therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone