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- Title
Autoimmunhämolytische Anämie vom Wärmetyp: Von der transfusionsmedizinischen Diagnostik zu Antikörper-Repertoires.
- Authors
Stahl, Dorothea; Sibrowski, W.
- Abstract
Warm autoimmune haemolytic anaemia (WAIHA) is characterized by an accelerated clearance of red blood cells (RBC) due to RBC-bound autoanti-bodies. Patients suffer from insufficient tissue oxygena-tion. Therapy symptomatically aims at raising tissue oxygenation by transfusion of allogeneic RBC. However, the effect of RBC transfusion is limited since substituted allogeneic RBC are cleared as rapidly as auto-logous RBC. „Causal“ therapeutic approaches suppress autoreactive B cells unspecifically by steroids or by chemotherapy and remove the site of destruction of autoantibody-coated RBC by splenectomy. Such therapeutic efforts are charged with a high risk of side effects, frequently do not act rapidly enough, and - in some cases - do not lead to any beneficial effect at all. The inefficiency of current therapeutic approaches indicates that the pathogenesis of WAIHA is not fully understood yet. Mechanisms leading to enhanced extravascular clearance of autoantibody-coated RBC in WAIHA have been extensively investigated, whereas mechanisms leading to occurrence and binding of anti-RBC autoantibodies still need to be clarified. Natural autoreactivity toward RBC antigens, tightly regulated, exists under physiological conditions in healthy individuals. Understanding the regulation of natural autoreactivity toward RBC antigens might give new insights into the mechanisms of an impaired tolerance toward RBC antigens in WAIHA. The present review summarizes current immuno-haematological diagnostic procedures in the care of patients with WAIHA and outlines present research on (dys-)regulation of natural autoreactivity toward RBC antigens in WAIHA.
- Publication
Journal of Laboratory Medicine / Laboratoriums Medizin, 2002, Vol 26, Issue 7/8, p389
- ISSN
0342-3026
- Publication type
Article