Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders

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, aut...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-01, Vol.10 (3), p.423
Main Authors: Bianco, Cristiana, Coluccio, Elena, Prati, Daniele, Valenti, Luca
Format: Article
Language:English
Subjects:
Anemia
Antibodies
Cholangitis
Clinical medicine
Crohn's disease
Hepatitis
Hypertension
Inflammation
Inflammatory bowel disease
Iron
Liver diseases
Liver transplants
Medical prognosis
Remission (Medicine)
Review
Steroids
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Summary: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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10030423