Immune Mediated Haemolytic Anaemia - Revision history

Fiorecastro at 16:34, 11 April 2022

2022-04-11T16:34:53Z

Fiorecastro: /* Laboratory Tests */

2022-03-16T13:15:00Z

Laboratory Tests

JoeWright at 08:57, 16 March 2022

2022-03-16T08:57:20Z

Fiorecastro at 16:29, 15 March 2022

2022-03-15T16:29:07Z

Fiorecastro at 20:57, 7 March 2022

2022-03-07T20:57:30Z

Fiorecastro at 18:25, 7 March 2022

2022-03-07T18:25:04Z

ElzaTriegaardt: /* Haematology */

2014-03-06T05:06:50Z

Haematology

ElzaTriegaardt: /* Haematology */

2014-03-06T05:05:40Z

Haematology

Bara at 12:10, 9 August 2012

2012-08-09T12:10:48Z

Bara at 22:46, 10 October 2011

2011-10-10T22:46:14Z

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 IMHA may occur as a '''primary''' disease with no apparent cause or it may be '''secondary''' to another systemic insult. Possible secondary causes of IMHA include bacterial and parasite infections (including ''[[Babesia canis]]'' in dogs and ''[[Feline Infectious Anaemia|Mycoplasma haemofelis]]'' in cats), adverse drug reactions, neoplasia (especially myeloproliferative and lymphoproliferative disease) and live vaccines, although the association between vaccination and immune-mediated disease remains controversial.
-Primary IMHA results from the formation of antibodies which are specifically directed against the hosts’ erythrocytes. Secondary IMHA occurs when antibodies directed against non-erythrocyte antigens also attach to RBCs. Antibody coated erythrocytes have a decreased lifespan, they are prematurely removed from the circulation by splenic and hepatic macrophages. Antibodies which fix complement can cause intravascular haemolysis. Primary IMHA is idiopathic. Secondary IMHA, the most common form seen in cats, may be secondary to certain drugs (potentiated sulphonamides, anti-thyroid drugs), lymphoid neoplasia, infection (bacterial, FeLV, haemotrophic Mycoplasma spp). References: [[NationWide Laboratories]]
+The majority of cases of IMHA affect only the circulating red blood cells resulting in a strongly [[Regenerative and Non-Regenerative Anaemias|regenerative anaemia]] as the bone marrow stem cells respond to the disease. In a small number of cases, antibodies are produced that affect the stem cells of the [[Erythropoiesis|erythroid lineage]] in the bone marrow, resulting in a non-regenerative anaemia that still bears many of the same clinical features as IMHA. Although the two diseases have been considered separately in the past, they really represent two ends of a spectrum of immune-mediated disease directed at cells of the erythroid line.
 The widespread lysis of red blood cells causes disease in the following ways:
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 ===Laboratory Tests===
 On presentation, full biochemical and haematological analysis of blood samples are indicated to confirm the diagnosis and to obtain a baseline measurement to assess the efficacy of future treatment. Several tests are also available that have a higher specificity for the diagnosis of IMHA.
 ====Haematology====
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 <references/>
 {{review}}

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 The diagnosis of IMHA in cats is more problematic than in dogs. Spherocytosis and leucocytosis generally are not evident. Haemotrophic feline Mycoplasma spp., particularly Mycoplasma haemofelis, induce IMHA. Blood film examination is poorly sensitive; PCR assay is indicated in all cases of suspected feline IMHA. FIA related anaemia is strongly regenerative unless there is coexisting FeLV infection.
-References: [[NationWide Laboratories]]
+Laboratory testes References: [[NationWide Laboratories]]
 ====Haematology====

← Older revision		Revision as of 08:57, 16 March 2022
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	11. [[NationWide Laboratories]]		11. [[NationWide Laboratories]]
		+	[[File:NationWide Logo.jpeg\|right\|link=https://www.nwlabs.co.uk/\|alt=NationWide Logo\|240x240px\|In Partnership with NationWide Laboratories\|frameless\|thumb\|]]
	{{review}}		{{review}}

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 <references/>
+. [[NationWide Laboratories]]
 {{review}}

@@ Line 11: / Line 11: @@
 IMHA may occur as a '''primary''' disease with no apparent cause or it may be '''secondary''' to another systemic insult. Possible secondary causes of IMHA include bacterial and parasite infections (including ''[[Babesia canis]]'' in dogs and ''[[Feline Infectious Anaemia|Mycoplasma haemofelis]]'' in cats), adverse drug reactions, neoplasia (especially myeloproliferative and lymphoproliferative disease) and live vaccines, although the association between vaccination and immune-mediated disease remains controversial.
-Primary IMHA results from the formation of antibodies which are specifically directed against the hosts’ erythrocytes. Secondary IMHA occurs when antibodies directed against non-erythrocyte antigens also attach to RBCs. Antibody coated erythrocytes have a decreased lifespan, they are prematurely removed from the circulation by splenic and hepatic macrophages. Antibodies which fix complement can cause intravascular haemolysis. Primary IMHA is idiopathic. Secondary IMHA, the most common form seen in cats, may be secondary to certain drugs (potentiated sulphonamides, anti-thyroid drugs), lymphoid neoplasia, infection (bacterial, FeLV, haemotrophic Mycoplasma spp). References: [[/en.wikivet.net/NationWide Laboratories|NationWide Laboratories]]
+Primary IMHA results from the formation of antibodies which are specifically directed against the hosts’ erythrocytes. Secondary IMHA occurs when antibodies directed against non-erythrocyte antigens also attach to RBCs. Antibody coated erythrocytes have a decreased lifespan, they are prematurely removed from the circulation by splenic and hepatic macrophages. Antibodies which fix complement can cause intravascular haemolysis. Primary IMHA is idiopathic. Secondary IMHA, the most common form seen in cats, may be secondary to certain drugs (potentiated sulphonamides, anti-thyroid drugs), lymphoid neoplasia, infection (bacterial, FeLV, haemotrophic Mycoplasma spp). References: [[NationWide Laboratories]]
 The majority of cases of IMHA affect only the circulating red blood cells resulting in a strongly [[Regenerative and Non-Regenerative Anaemias|regenerative anaemia]] as the bone marrow stem cells respond to the disease. In a small number of cases, antibodies are produced that affect the stem cells of the [[Erythropoiesis|erythroid lineage]] in the bone marrow, resulting in a non-regenerative anaemia that still bears many of the same clinical features as IMHA. Although the two diseases have been considered separately in the past, they really represent two ends of a spectrum of immune-mediated disease directed at cells of the erythroid line.
@@ Line 42: / Line 42: @@
 The diagnosis of IMHA in cats is more problematic than in dogs. Spherocytosis and leucocytosis generally are not evident. Haemotrophic feline Mycoplasma spp., particularly Mycoplasma haemofelis, induce IMHA. Blood film examination is poorly sensitive; PCR assay is indicated in all cases of suspected feline IMHA. FIA related anaemia is strongly regenerative unless there is coexisting FeLV infection.
-References: [[/en.wikivet.net/NationWide Laboratories|NationWide Laboratories]]
+References: [[NationWide Laboratories]]
 ====Haematology====

@@ Line 33: / Line 33: @@
 ====Haematology====
-Affected animals have a reduced [[Packed Cell Volume|packed cell volume]] (PCV) or haematocrit (HCT) and often a reduced haemoglobin concentration.  IMHA causes a strongly [[Regenerative and Non-Regenerative Anaemias|regenerative anaemia]] and evidence of macrocytosis (increased MCV) should be apparent after 48-72 hours in dogs. A blood smear is extremely useful in evaluating cases of IMHA as '''spherocytes''' [http://www.medvet.umontreal.ca/clinpath/banq-im/hematology/SpherocytesE.htm Spherocytes]are often visible. These small, dense red blood cells are formed due to partial phagocytosis of red blood cells by the MPS. Polychromasia should also be visible on a blood smear from an animal undergoing regeneration and reticulocytosis can be confirmed using a supravital stain such as new methylene blue.
+Affected animals have a reduced [[Packed Cell Volume|packed cell volume]] (PCV) or haematocrit (HCT) and often a reduced haemoglobin concentration.  IMHA causes a strongly [[Regenerative and Non-Regenerative Anaemias|regenerative anaemia]] and evidence of macrocytosis (increased MCV) should be apparent after 48-72 hours in dogs. A blood smear is extremely useful in evaluating cases of IMHA as [http://www.medvet.umontreal.ca/clinpath/banq-im/hematology/SpherocytesE.htm spherocytes]are often visible. These small, dense red blood cells are formed due to partial phagocytosis of red blood cells by the MPS. Polychromasia should also be visible on a blood smear from an animal undergoing regeneration and reticulocytosis can be confirmed using a supravital stain such as new methylene blue.
 Reactive [[Platelet Abnormalities|thrombocytosis]] and leucocytosis may be present with any cause of anaemia.

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 Also known as: '''''IMHA — Autoimmune haemolytic anaemia (AIHA) — Pure red cell aplasia (PRCA)
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 {{review}}
 [[Category:Antibody Mediated Autoimmune Diseases]]
 [[Category:Immunological Diseases - Dog]][[Category:Lymphoreticular and Haematopoietic Diseases - Dog]][[Category:Lymphoreticular and Haematopoietic Diseases - Cat]][[Category:Immunological Diseases - Cat]]
 [[Category:Expert Review - Small Animal]]

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 Also known as: '''''IMHA — Autoimmune haemolytic anaemia (AIHA) — Pure red cell aplasia (PRCA)
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 Most mortality occurs in the first two weeks after presentation and, overall, 30-50% of animals would be expected to survive for at least one year after initial treatment for IMHA<ref>'''Idiopathic immune-mediated hemolytic anemia: treatment outcome and prognostic factors in 149 dogs.''' ''Piek CJ, Junius G, Dekker A, Schrauwen E, Slappendel RJ, Teske E.'' J Vet Intern Med. 2008 Mar-Apr;22(2):366-73. Epub 2008 Mar 10.</ref>.
-==Literature Search==
+{{Learning
-[[File:CABI logo.jpg|left|90px]]
+|literature search = [http://www.cabdirect.org/search.html?options6=OR&calendarInput=yyyy-mm-dd&occuring1=title&rowId=1&rowId=2&rowId=3&rowId=4&rowId=5&rowId=6&show=all&options1=AND&occuring5=title&options2=OR&occuring4=title&options3=OR&occuring3=title&options4=OR&options5=OR&occuring2=title&publishedend=yyyy&fq=sc%3A%22ve%22&q6=PRCA&q5=%22Pure+red+cell+aplasia%22&it=any&q2=IMHA&q1=%22Immune+Mediated+Haemolytic+Anaemia%22&q4=AIHA&q3=%22Autoimmune+haemolytic+anaemia%22&la=any&publishedstart=yyyy&occuring6=title&y=8&x=45 Immune Mediated Haemolytic Anaemia publications]
+|flashcards = [[Small Animal Emergency and Critical Care Medicine Q&A 20]]
+}}
 ==References==
 <references/>
 [[Category:Antibody Mediated Autoimmune Diseases]]
 [[Category:Immunological Diseases - Dog]][[Category:Lymphoreticular and Haematopoietic Diseases - Dog]][[Category:Lymphoreticular and Haematopoietic Diseases - Cat]][[Category:Immunological Diseases - Cat]]
-[[Category:Expert Review]]
+[[Category:Expert Review - Small Animal]]