RESUMO
BACKGROUND: Autoimmune hemolytic anemia (AIHA) results from red cell destruction due to circulating autoantibodies against red cell membrane antigens. They are classified etiologically into primary and secondary AIHAs. A positive direct antiglobulin test (DAT) is the hallmark of diagnosis for AIHA. METHODS AND RESULTS: One hundred and seventy-five AIHA cases diagnosed based on positive DAT were included in the study. The cases showed a female predilection (M: F = 1:2.2) and a peak incidence in the third decade. Forty cases were found to be due to primary AIHA, while a majority (n = 135) had AIHA secondary to other causes. The primary AIHA cases had severe anemia at presentation (65%) and more often showed a blood picture indicative of hemolysis (48%). Forty-five percent of primary AIHAs showed positivity for both DAT and indirect antiglobulin test (IAT). Connective tissue disorders were the most common associated etiology in secondary AIH A0 (n = 63). CONCLUSION: AIHAs have a female predilection and commonly present with symptoms of anemia. AIHA secondary to other diseases (especially connective tissue disorders) is more common. Primary AIHAs presented with severe anemia and laboratory evidence of marked hemolysis.
RESUMO
Bleeding is a common manifestation of inherited and acquired disorders of haemostasis. Acquired disorders of haemostasis can be of varied etiology like liver disease, DIC, haemorrhagic disease of newborn and inhibitors to coagulation factors. Inhibitors to coagulation factors are an unusual cause of bleeding which can be superimposed on inherited factor deficiencies or sometimes resembles them. The clinical and haematological profile to two cases of factor VIII inhibitors are being presented here, one of which was a known haemophiliac receiving factor VIII therapy and another was a elderly lady with no other apparent underlying disorder. Hence any case of factor VIII deficiency who becomes refractory to factor VIII replacement therapy or those who are detected to have factor deficiency late in life should be investigated for inhibitors.
