Literature review of Immune Mediated Haemolytic anaemia and four case examples

Abstract

ABSTRACT: Immune mediated haemolytic anaemia (IMHA) is one of the most common forms of anaemia seen in small animal medicine practices. It can occur primary or secondary to an underlying disease. IMHA occurs to antibodies and/or a compliment being attached to the red blood cell membrane causing them to bephagocytosed earlier than normal. The destruction of RBCs may occur intravascularly or extravascularly. Clinical signs of IMHA includes lethargy, pale mucous membranes, anorexia, dypsnoea and in intravascular cases, icterus and pigmenturia. The disease isdiagnosed based on clinical signs and laboratory findings. On the laboratory findings, the presence of spherocytes, autoagglutination or a positive Coomb’s test is regarded as a conclusive in the diagnosis of IMHA. The treatment involved immunosuppression, where glucocorticoids are the most commonly used group of drugs. Azathioprine, Mycophenolate-mofetil and human intravenous immunoglobulin are also drugs that are being used as immunosuppression in animals diagnosed with IMHA. Supportive treatment to prevent thromboembolisms and gastric ulcers are being used. In severe cases, blood transfusions and splenectomy may be indicated. More research is needed on the field of treatment, as of now the mortality of IMHA patients are high and range from 22-80%. It is believed that most patients die from pulmonary thromboembolisms.