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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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Published in: | Journal of clinical medicine 2021-01, Vol.10 (3), p.423 |
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description | 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. |
doi_str_mv | 10.3390/jcm10030423 |
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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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10030423</identifier><identifier>PMID: 33499290</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>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</subject><ispartof>Journal of clinical medicine, 2021-01, Vol.10 (3), p.423</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. 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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.</description><subject>Anemia</subject><subject>Antibodies</subject><subject>Cholangitis</subject><subject>Clinical medicine</subject><subject>Crohn's disease</subject><subject>Hepatitis</subject><subject>Hypertension</subject><subject>Inflammation</subject><subject>Inflammatory bowel disease</subject><subject>Iron</subject><subject>Liver diseases</subject><subject>Liver transplants</subject><subject>Medical prognosis</subject><subject>Remission (Medicine)</subject><subject>Review</subject><subject>Steroids</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><recordid>eNpdkV1LHDEUhoO0qFivvJdAbwplbTLJ5OOmsPWzsNJe6HXIZM6sWSaJTWaU_feOusrWc5MDeXh4Dy9CR5ScMKbJj5ULlBBGeMV20H5FpJwRptinrX0PHZayItMoxSsqd9EeY1zrSpN91Jx5u4yp-IJtbPG1jXYJAeKAU4fn45B8CGMEfAUh9evBOzyPELzFPuK_dvATWfCjH-7wwj9AfpH8So_Q4zNfUm4hly_oc2f7Aoeb9wDdXpzfnF7NFn8uf5_OFzPHiR5mCmolGiF0C0pq2dUt4zVAI23bARDnXNNq3oGgIOumoQw6yoRSlnWKgXbsAP189d6PTYDWTdGy7c199sHmtUnWm_9_or8zy_RgpBI103oSfNsIcvo3QhlM8MVB39sIaSym4ooKTmpBJ_TrB3SVxhyn80wlOCWcSion6vsr5XIqJUP3HoYS81yf2apvoo-387-zb2WxJ6v8lys</recordid><startdate>20210122</startdate><enddate>20210122</enddate><creator>Bianco, Cristiana</creator><creator>Coluccio, Elena</creator><creator>Prati, Daniele</creator><creator>Valenti, Luca</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4611-6781</orcidid><orcidid>https://orcid.org/0000-0001-8909-0345</orcidid></search><sort><creationdate>20210122</creationdate><title>Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders</title><author>Bianco, Cristiana ; 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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 |
title | Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders |
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