(精选)【医学课件课件】 Immune Hemolytic Anemias (IHA)教学课件.pptVIP

Marrow cellularity (×100) Marrow smear (×1000) No.5 is the result of Coombs test of the patient DAT(anti IgG+anti C3) 1 2 3 4 5 Discussing questions: 1. What is your primitive impression of the patient? Describe your evidence? 2. What clinical information do you need to support your diagnosis? 3. Which further tests do you need to complete the diagnosis? 4. Why the patient had black urine. MYELOPATHIC ANEMIAS These anemias are due to the bone marrow infiltration or replacement by abnormal tissues such as malignant metastases, myelosclerosis, leukemia and myeloma. Secondary anemia Immune Hemolytic Anemias (IHA) Definition Classification Mechanism of hemolysis Characteristics in clinical and laboratory Diagnostic process Definition of IHA The shortened red cells life span is caused by the antigens existing on the surface of erythrocytes reacting with relative antibodies. This acquired hemolytic anemia is termed immune hemolytic anemia. IHA Classification 1. According to the cause of Ab production 2. According to the nature of Ab Autoimmunehemolytic anemia (AIHA) Drug-induced immune hemolytic anemia (DIHA) Allo-immune hemolytic anemia (ALIHA) temperature Warm Ab type (37 ℃，IgG) Cold Ab type (less than 37 ℃, IgM) Mixed Ab type I. Autoimmunehemolytic anemias (AIHAs) Definition AIHAs are a group of acquired hemolytic disorders that are the result of antibodies or complement binding to specific antigens on the RBC membrane, which leads to a shortened RBC life span and an increased RBC destruction. 1. IgG Warm Abs bind to RBCs at 37 ℃ but fail to agglutinate the RBCs. 2. Cold agglutinins almost always are of IgM subtype and clump RBCs at cold tempratures. (CAS) . 3. Donath-Landsteiner(IgG) Abs bind to RBCs in the cold and activate the hemolytic complement cascade when the RBCs are warmed to 37 ℃. (PCH) Antierythrocyte antibodies can be divided into three general categories: AIHA : Warm Antibody Type over