Clinical features and prognostic factors of adult autoimmune hemolytic anemia

Objective: To explore the clinical characteristics and prognostic influencing factors of adult autoimmune hemolytic anemia (AIHA), improve clinicians' awareness of this disease and reduce the misdiagnosis rate. Methods: This study was a retrospective single-center research from 2018 to 2023. Clinical data from adult AIHA were analyzed. Results: Forty-one patients were enrolled, of whom were 10 males and 31 females, average age (54.4±15.9) years. The common clinical symptoms of AIHA were anemia (97.6%), dizziness or fatigue (92.7%), jaundice (85.4%), hepatosplenomegalgia (53.7%), soy colored urine (26.8%), melena (19.5%), fever (12.2%), abdominal pain or vomiting (4.9%). The hemolytic indexes of Lactate dehydrogenase (LDH) (95.1%), total bilirubin (TBIL) (85.4%), ferritin (free) (92.7%) and reticulocyte (Ret) (97.6%) are elevated. Nine patients were misdiagnosed, with 8 patients being misdiagnosed as gastrointestinal hemorrhage and 1 patient being misdiagnosed as acute cholecystitis. The risk factors for poor prognosis were revealed through a simple analysis of hemoglobin (HB), C-reactive protein (CRP), glutamic oxaltransaminase (AST), and secondary etiology. HB level and secondary etiology were independently identified as risk factors for poor prognosis by logistic regression analysis. Conclusion: The incidence of adult AIHA is low, and the clinical symptoms are complex and non-specific. HB level and secondary etiology were independent risk factors for poor prognosis. Coomb , s Positive is an important diagnostic method, and Coomb , s negative cannot be ruled out. It is important to be familiar with the clinical characteristics of adult AIHA, improve the understanding of AIHA, and avoid misdiagnosis and mistreatment .