Direct Antiglobulin Testing with Various Techniques and Implications for IMHA

摘要

Immune-mediated hemolytic anemia (IMHA) is one of the most common and serious hemolytic anemias in dogs, but occurs rarely in other animal species. In IMHA an immune response, including anti-erythrocytic antibodies, complement and macrophages, targetsdirectly or indirectly erythrocytes and a hemolytic anemia ensues. There are many triggers for IMHA such as infections, drugs and other agents,- and cancer leading to secondary IMHA, but in many dogs no cause is identified (so-called idiopathic, autoimmune or primary IMHA) or a genetic predisposition has been proposed (Cocker spaniels). Furthermore, alloimmune hemolytic anemias, such as hemolytic transfusion reactions, both acute and delayed, and neonatal isoerythrolysis (only litters from transfused bitches) are caused by specific anti-erythrocytic alloantibodies. In contrast to other species, dogs with IMHA also develop an often overwhelming inflammatory response resulting in thrombosis and necrosis of various organs. And while the anemia can be corrected with transfusions, these complications in dogs are causing severe morbidity and mortality despite aggressive immunosuppression and antithrombotic interventions. A recent critical review on immunosuppressive therapeutics in IMHA revealed a lack ofevidence for efficacy and safety of any drugs short of glucocorticosteroids.