1. Dr. Y. Swapna Rotary Central TTK VHS Blood Bank Chennai – 600 113.

2. IS Blood Transfusion safe in Auto immune Hemolytic Anemia?

3. We have several referral cases of AIHA, We have successfully issued least incompatible Blood units; in most cases, the incompatibility grading was very much less severe compared to auto control. There were no untoward reactions or problems in the patients and the hemoglobin was also found to increase .

4. A 40 year old female patient was posted for hysterectomy (for menorrhagia due to Fibroid uterus) with Hb 7gms%
She was suggested Blood Transfusion to increase Hb. There is previous history of uneventful whole Blood Transfusion for anemia, about 6 months back.
Now she could not obtain compatible Blood units in any centre and hence was referred to VHS.

5. OnTesting: - Auto Control (Ig G phase) and Direct Coomb’s Tests were positive.
The Blood units were cross matched by comprehensive compatibility Techniques.
Incompatibility was observed by Bovine Albumin, Room Temperature, 37.C. and Indirect Coomb’s Technique.
The antibody detected on 3 cell panel and 11 cell panel was found to be anti – e. Titre is 1:256

8. Other parameters suggestive of hemolysis are normal
Noh/o Drug Intake,
Infections Ruled out.
SLE,RA,CLL were ruled out.
Result: - Warm type of anti body of Rh specificity acting against self antigen ‘e’, also documented to act as allo antibody.

9. Discussion: - In few cases of AIHA, Blood units were issued if found to be least incompatible; after cross matching many units. In this case, this was not possible as the incompatibility was severe. So the Hematologist suggested immuno suppressives, hematinics and autologous Transfusion.

10. Conclusion: - This is a case of idiopathic warm type of AIHA
Conclusion: - This is a case of idiopathic warm type of AIHA., Blood Transfusion would be ideal with the corresponding antigen negative blood unit. If not available, least incompatible blood units and corticosteroids form the basis of treatment ,based on the severity of anemia.

11. References : - Mollison’s Blood Transfusion in clinical practice 11th Edition
: de Gruchy’s Clinical
Hematology in medical Practice 5th Edition
: AABB Technical Manual, 14th Edition.
: A manual of Hemotherapy

12. Thank you