Acquired Haemolytic Anaemia in Children Diagnostic Approach and Management

Autoimmune Haemolytic Anaemia (AIHA) is not very uncommon in childhood and mainly caused by the presence of auto-antibodies directed against antigens on the surface of red blood cells, leading to premature destruction of the cells. Many children are hospitalized every year due to sequelae of this heterogeneous group of disorders to which paediatric haematologist take a variety of diagnostic and therapeutic approaches. AIHA is generally categorized as "warm" or "cold" based on the thermal reactivity of the autoantibodies and is further classified as primary (idiopathic) or secondary. Early recognition and diagnosis are very important for successful management and outcome of haemolytic anaemia. The evaluation of suspected immune haemolytic anaemia includes a thorough history, physical examination and laboratory workup assessing for evidence of acute haemolytic anaemia, possible diagnosis of an acute event, to evaluate for concurrent causes and to rule out alternative causes. In this review article we will discuss the classification, diagnostic approach and general management of haemolytic anaemia in children especially focusing on newly diagnosed autoimmune haemolytic anaemia.