Clinical profile and serological correlation with haemolysis in DAT-positive autoimmune haemolytic anaemia patients in Bangladesh

Anika Mahmood; Ayesha Khatun; Mahamudul Hasan; Sonia Shormin Miah; Md Mazharul Hoque Tapan; Atiar Rahman

doi:10.1016/j.pathol.2023.12.417

Clinical profile and serological correlation with haemolysis in DAT-positive autoimmune haemolytic anaemia patients in Bangladesh

Pathology. 2024 Feb 24:S0031-3025(24)00080-1. doi: 10.1016/j.pathol.2023.12.417. Online ahead of print.

Authors

Anika Mahmood¹, Ayesha Khatun², Mahamudul Hasan³, Sonia Shormin Miah², Md Mazharul Hoque Tapan⁴, Atiar Rahman²

Affiliations

¹ Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Electronic address: anika.mahmood59@gmail.com.
² Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
³ Intensive Critical Unit, Shaheed Khaleque-Ibrahim General Hospital, Dhaka, Bangladesh.
⁴ Director General Health Services (DGHS), Bangladesh.

PMID: 38480050
DOI: 10.1016/j.pathol.2023.12.417

Abstract

Discerning the type of autoimmune haemolytic anaemia (AIHA) is crucial for transfusion support and initiation of treatment. This study aimed to establish the clinical profile and serological character of red cell autoantibodies and to investigate the relationship with haemolysis in AIHA patients who were direct antiglobulin test (DAT)-positive. A total of 59 DAT-positive AIHA patients were included in this study. Clinical, laboratory and serological findings were evaluated to find the gradation of haemolysis and to investigate its correlation with age, sex, type of autoantibody and level of autoantibody. Study findings revealed that most patients (89.8%) had haemolysis, wherein moderate haemolysis (67.8%) was predominant. Weakness, palpitations, fever, pallor, tachycardia and splenomegaly were common among patients with severe and moderate haemolysis. The majority (66.1%) had an associated disorder. Warm autoantibody was the most common, followed by cold and mixed cases. The severity of haemolysis correlated strongly with the strength of the DAT reaction (Cramer V 0.636, p<0.001). These findings may be useful to clinicians while determining a treatment plan. The direct relationship between severity of haemolysis and strength of DAT needs further exploration in a large population to establish whether it can be used as a tool to formulate a treatment plan when assessing AIHA patients in low resourced countries.

Keywords: AIHA; DAT; Red cell autoantibody; clinical profile; haemolysis.