Pathogenesis, risk factors and therapeutic options for autoimmune haemolytic anaemia in the post‐transplant setting

2021 ◽  
Author(s):  
Maria Gabelli ◽  
Christine Ademokun ◽  
Nichola Cooper ◽  
Persis I. Amrolia
Keyword(s):  
Risk Factors ◽  
Haemolytic Anaemia ◽  
Therapeutic Options ◽  
Autoimmune Haemolytic Anaemia ◽  
Post Transplant

scholarly journals EPIDEMIOLOGY AND RISK FACTORS OF WARM AND COLD AUTOIMMUNE HEMOLYTIC ANEMIA

InterConf ◽  
2021 ◽  
pp. 225-232
Author(s):  
Vasile Musteata ◽  
Aslam Thoufeeq
Keyword(s):  
Risk Factors ◽  
Hemolytic Anemia ◽  
Clinical Features ◽  
Haemolytic Anaemia ◽  
Autoimmune Hemolytic Anemia ◽  
Medical Literature ◽  
Current Medical ◽  
Autoimmune Haemolytic Anaemia ◽  
Coombs Test ◽  
Different Types

Even though clinical features in autoimmune haemolytic anaemia vary according to the type of AIHA, anaemic syndrome stays common for most of the cases. A positive Coombs test or direct anti-globulin test developed in 1945 by Coombs, Mourant and Race, is the most deciding factor in AIHA diagnosis. Since the immunologic mechanisms causing erythrocyte destruction vary between AIHAs, treatment is also different. Empirical approach with glucocorticoids is the main treatment of AIHA overall, but less effective in CAD. However, the current medical literature is still with gaps concerning the management, presentation and diagnosis of the different types of AIHA altogether.

scholarly journals Hard-To-Treat Idiopathic Refractory Autoimmune Haemolytic Anaemia with Reticulocytopenia

2020 ◽  
Author(s):  
Marcelo Aveiro ◽  
Gisela Ferreira ◽  
Carla Matias ◽  
Ana Oliveira ◽  
Tatiana Rodrigues
Keyword(s):  
Haemolytic Anaemia ◽  
Great Majority ◽  
Therapeutic Options ◽  
Autoimmune Haemolytic Anaemia ◽  
Rare Presentation ◽  
Prednisolone Dose ◽  
Epoetin Beta ◽  
Poor Outcome ◽  
Great Severity ◽  
Uncommon Condition

Autoimmune haemolytic anaemia (AIHA) is an uncommon condition characterized by increased destruction of erythrocytes associated with reticulocytosis in the great majority of cases. We present the case of a 68-year-old woman with jaundice and malaise. Investigation revealed AIHA with reticulocytopenia. The patient failed to respond to prednisolone or to rituximab. Azathioprine and epoetin beta were subsequently started, the prednisolone dose was increased, and the patient began to respond after 1 month. In AIHA, reticulocytopenia is a very rare presentation and a sign of great severity and poor outcome. The scarcity of therapeutic options in refractory cases poses a major challenge for physicians.  

Vulvovaginal Candidiasis: Epidemiology and Risk Factors, Pathogenesis, Resistance, and New Therapeutic Options

2021 ◽  
Author(s):  
Janaina de Cássia Orlandi Sardi ◽  
Diego Romário Silva ◽  
Paula Cristina Anibal ◽  
Julianna Joanna Carvalho Moraes de Campos Baldin ◽  
Suellen Rodrigues Ramalho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vulvovaginal Candidiasis ◽  
Therapeutic Options

scholarly journals Epidemiology of Secondary Warm Autoimmune Haemolytic Anaemia—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1244
Author(s):  
Stinne Tranekær ◽  
Dennis Lund Hansen ◽  
Henrik Frederiksen
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Underlying Disease ◽  
Age At Diagnosis ◽  
Autoimmune Haemolytic Anaemia ◽  
Sex Distribution ◽  
Number Of Patients ◽  
Study Results ◽  
Full Text Review

Background: Warm autoimmune haemolytic anaemia (wAIHA) is a haemolytic disorder, most commonly seen among adults and is classified as either primary or secondary to an underlying disease. We describe the age and sex distribution and the proportion of secondary wAIHA. Method: We retrieved 2635 published articles, screened abstracts and titles, and identified 27 articles eligible for full-text review. From these studies, we extracted data regarding number of patients, sex distribution, age at diagnosis, number of patients with secondary wAIHA, and whether the patients were diagnosed through local or referral centres. All data were weighted according to the number of included patients in each study. Results: 27 studies including a total of 4311 patients with wAIHA, of which 66% were females, were included. The median age at diagnosis was 68.7 years, however, wAIHA affected all ages. The mean proportion of secondary wAIHA was 49%, most frequently secondary to systemic lupus erythematosus. The proportions of secondary wAIHA reported from primary vs. referral centres were 35% vs. 59%, respectively. Conclusion: This review consolidates previously reported gender distribution. The higher proportion of secondary wAIHA in referral centres suggests that the most severely affected patients are disproportionally more frequent in such facilities.

scholarly journals Calcium and phosphate levels after kidney transplantation and long-term patient and allograft survival

2020 ◽  
Author(s):  
Julio Chevarria ◽  
Donal J Sexton ◽  
Susan L Murray ◽  
Chaudhry E Adeel ◽  
Patrick O’Kelly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Transplant ◽  
Graft Failure ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Post Transplant ◽  
All Cause Mortality ◽  
Transplant Function ◽  
The Republic ◽  
The Impact

Abstract Background Non-traditional cardiovascular risk factors, including calcium and phosphate derangement, may play a role in mortality in renal transplant. The data regarding this effect are conflicting. Our aim was to assess the impact of calcium and phosphate derangements in the first 90 days post-transplant on allograft and recipient outcomes. Methods We performed a retrospective cohort review of all-adult, first renal transplants in the Republic of Ireland between 1999 and 2015. We divided patients into tertiles based on serum phosphate and calcium levels post-transplant. We assessed their effect on death-censored graft survival and all-cause mortality. We used Stata for statistical analysis and did survival analysis and spline curves to assess the association. Results We included 1525 renal transplant recipients. Of the total, 86.3% had hypophosphataemia and 36.1% hypercalcaemia. Patients in the lowest phosphate tertile were younger, more likely female, had lower weight, more time on dialysis, received a kidney from a younger donor, had less delayed graft function and better transplant function compared with other tertiles. Patients in the highest calcium tertile were younger, more likely male, had higher body mass index, more time on dialysis and better transplant function. Adjusting for differences between groups, we were unable to show any difference in death-censored graft failure [phosphate = 1.14, 95% confidence interval (CI) 0.92–1.41; calcium = 0.98, 95% CI 0.80–1.20] or all-cause mortality (phosphate = 1.10, 95% CI 0.91–1.32; calcium = 0.96, 95% CI 0.81–1.13) based on tertiles of calcium or phosphate in the initial 90 days. Conclusions Hypophosphataemia and hypercalcaemia are common occurrences post-kidney transplant. We have identified different risk factors for these metabolic derangements. The calcium and phosphate levels exhibit no independent association with death-censored graft failure and mortality.

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