Diagnosis Age*/Sex DAT Procedure Replacement Fluid Clinical Response Outcome Reference
WAIHA
Post-infectious†
40/M IgG+
C3+
Phlebotomy (900 mL)
+
Plasmapheresis (2400 mL)
2 pRBC 700 mL WB,
450 mL plasma
500 mL Haemaccel
Rapid Improvement
Afebrile
Stable Hgb
Decreased hemolysis
Improved renal function
Decreased DAT
Survived Garelli [14]
Refractory CLL
WAIHA
Volume overload
54/F IgG+ 2L WBEx using
Infusion pumps
Reconstituted RBC (saline, albumin, plasmalyte,plasma) Improvement
Decreased DAT
Survived Becker [15]
WAIHA‡ 19/M IgG+ ± C3+ WBEx
(4300 mL)
WB Rapid improvement
Decreased hemolysis
Improved oxygenation
Decreased DAT
Survived This case
SCID
Haploidential-BMT
IgM-WAIHA
0.9/F C3+ WBEx WB None
Ongoing hemolysis
Autoagglutination
CVA x 2
Deceased Friedmann [4]
Evan’s Syndrome
IgM-WAIHA
9/F C3+ WBEx WB None
Ongoing hemolysis
Autoagglutination
Multiple CVA
Pulmonary emboli
Renal failure
Ischemic gangrene
Deceased Nowak-Wegrzyn[5]
Mycoplasma
Anti-Pr cold AIHA
41/M C3+ WBEx WB None Deceased Schonitzer [16]
BMT: Bone Marrow Transplantation; CVA: CerebroVascular Accident; CLL: Chronic Lymphocytic Leukemia; DAT: Direct Antiglobulin Test; SCID: Severe Combined Immuno Deficiency.
* Age in years
†Upper respiratory tract infection with fever in the last month.
‡Presumed post-infectious
Table 1: Use of whole blood exchange in AIHA.