pregnancy complicated by autoimmune hemolytic anemia

Autoimmune hemolytic anemia (AIHA) is a hemolytic anemia caused by dysregulation of the patient's immune function, resulting in the production of autoantibodies and/or complement adsorbed on the surface of red blood cells, leading to accelerated destruction of red blood cells. Autoimmune hemolytic anemia is uncommon. Chaplin (1973) reported a case of pregnancy complicated by idiopathic autoimmune hemolytic anemia. The cause of abnormal antibody production remains unclear. Anemia may be caused by active autoantibodies (80%-90%), inactive antibodies, or bound antibodies. This anemia can be divided into two major categories: primary (idiopathic) immune hemolysis and secondary, the latter including lymphoma, leukemia, connective tissue diseases, certain infectious diseases, chronic infectious diseases, and drug-induced factors. In many cases, initially considered primary, it is later found to be caused by an underlying disease. Patients have positive direct or indirect anti-human globulin (Coombs) tests, and the antibodies may be anti-red blood cell IgM and IgG. Mycoplasma pneumoniae and infectious mononucleosis can cause cold agglutinin antibodies. In women with this disease, hemolysis may worsen during pregnancy. Glucocorticoid therapy is effective, with prednisone 1 mg/(kg·d). If accompanied by thrombocytopenia, the platelet count may also be corrected.