sami,mishyd,medicineking can u suggest answer for - geethavijay

[ArchivalUser]

what about cold vs warm AIHA? treatment.... i think there are some differences

[ArchivalUser]

COLD DOES NOT RESPOND TO STEROIDS. Usual treatment is treating etiology like mycoplasma etc if you can find an etiology. Otherwise, rx with Rituximab

[ArchivalUser]

but those drugs take 4 months to act what the tx meanwhile if no response to steroid

[ArchivalUser]

IF THE PATIENT IS NOT SEVERELY SYMPTOMATIC, TRANSFUSE AS NEEDED and allow for the drug to act. If very very symptomatic, can use plasmapheresis to remove cold antibody

[ArchivalUser]

meaning
1 steroid
2- no respone Transfusion
3- Plasmapheresis
4 until patient do splenectomy or not / or use drug like Rituximab

[ArchivalUser]

No use of steroids in Cold AIHA. "Prednisone does not diminish antibody production and any benefit is mediated by downregulation of phagocytosis, which typically requires unacceptably high doses."

Avoid cold exposure. Start with rituximab. If rituximab is not working , can go for splenectomy . Most times, cold AIHA spontaneously resloves

Plasmapheresis only if SEVERELY symptomatic and massive hemolysis. Transfusion is as needed only in symptoms. ( use warmed blood products).

[ArchivalUser]

Clear Thanks