Immune hemolytic anemia can be either isoimmune or autoimmune. Isoimmune hemolytic anemia results from a mismatched blood transfusion or from hemolytic disease in the newborn. In autoimmune hemolytic anemia (AIHA), shortened red cell survival is caused by the action of immunoglobulins, with or without the participation of complement on the red cell membrane. The red cell autoantibodies may be of the warm type, the cold type, or the cold-warm Donath-Landsteiner type. Complement participation is usually confined to the IgM type of antibody; only rarely is it associated with IgG. AIHA may be idiopathic or secondary to a number of conditions listed in Table 7-2.
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