Download PDF
CC BY 4.0 · TH Open 2021; 05(01): e8-e13
DOI: 10.1055/s-0040-1721733
Review Article

Autoimmune Hemolytic Anemia and Pulmonary Embolism: An Association to Consider

Daria Solari
1   Division and Central Laboratory of Hematology, Department of Oncology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Lorenzo Alberio 
1   Division and Central Laboratory of Hematology, Department of Oncology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Camillo Ribi 
2   Division of Immunology and Allergy, Department of Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Francesco Grandoni 
1   Division and Central Laboratory of Hematology, Department of Oncology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Gregoire Stalder 
1   Division and Central Laboratory of Hematology, Department of Oncology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Autoimmune hemolytic anemia (AIHA) is increasingly recognized as a strong risk factor for venous thrombosis. However, there are currently no guidelines on thromboembolism prevention and management during AIHA. Here, we describe the case of a patient with AIHA and pulmonary embolism and resume the current knowledge on epidemiology, risk factors, treatment, and pathophysiology of thrombosis during AIHA, as well as new therapeutic perspectives to prevent thrombus formation during AIHA.

Keywords

anticoagulant prophylaxis - autoimmune hemolytic anemia - complication - venous thromboembolism

Note

Signed informed consent was obtained from the patient included in this work.


Authors' Contributions

D.S. and G.S. conceived the study, performed the literature research, and prepared the manuscript. L.A., C.R., and F.G. wrote, commented, and corrected the manuscript.




Publication History

Received: 03 June 2020

Accepted: 05 November 2020

Article published online:
17 January 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Kalfa TA. Warm antibody autoimmune hemolytic anemia. Hematology (Am Soc Hematol Educ Program) 2016; 2016 (01) 690-697
    CrossrefPubMedGoogle Scholar
  • 2 Go RS, Winters JL, Kay NE. How I treat autoimmune hemolytic anemia. Blood 2017; 129 (22) 2971-2979
    CrossrefPubMedGoogle Scholar
  • 3 Hill QA, Stamps R, Massey E, Grainger JD, Provan D, Hill A. British Society for Haematology. The diagnosis and management of primary autoimmune haemolytic anaemia. Br J Haematol 2017; 176 (03) 395-411
    CrossrefPubMedGoogle Scholar
  • 4 Ungprasert P, Tanratana P, Srivali N. Autoimmune hemolytic anemia and venous thromboembolism: a systematic review and meta-analysis. Thromb Res 2015; 136 (05) 1013-1017
    CrossrefPubMedGoogle Scholar
  • 5 Ruggeri M, Rodeghiero F. Thrombotic risk in patients with immune haemolytic anaemia. Br J Haematol 2016; 172 (01) 144-146
    CrossrefPubMedGoogle Scholar
  • 6 Ramagopalan SV, Wotton CJ, Handel AE, Yeates D, Goldacre MJ. Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study. BMC Med 2011; 9: 1
    CrossrefPubMedGoogle Scholar
  • 7 Zöller B, Li X, Sundquist J, Sundquist K. Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden. Lancet 2012; 379 (9812): 244-249
    CrossrefPubMedGoogle Scholar
  • 8 Yusuf HR, Hooper WC, Beckman MG, Zhang QC, Tsai J, Ortel TL. Risk of venous thromboembolism among hospitalizations of adults with selected autoimmune diseases. J Thromb Thrombolysis 2014; 38 (03) 306-313
    CrossrefPubMedGoogle Scholar
  • 9 Yusuf HR, Hooper WC, Grosse SD, Parker CS, Boulet SL, Ortel TL. Risk of venous thromboembolism occurrence among adults with selected autoimmune diseases: a study among a U.S. cohort of commercial insurance enrollees. Thromb Res 2015; 135 (01) 50-57
    CrossrefPubMedGoogle Scholar
  • 10 Pullarkat V, Ngo M, Iqbal S, Espina B, Liebman HA. Detection of lupus anticoagulant identifies patients with autoimmune haemolytic anaemia at increased risk for venous thromboembolism. Br J Haematol 2002; 118 (04) 1166-1169
    CrossrefPubMedGoogle Scholar
  • 11 Hendrick AM. Auto-immune haemolytic anaemia--a high-risk disorder for thromboembolism?. Hematology 2003; 8 (01) 53-56
    CrossrefPubMedGoogle Scholar
  • 12 Bongarzoni V, Annino L, Roveda A, Amendolea MA, Tirindelli MC, Avvisati G. Risk of thromboembolism in patients with idiopathic autoimmune hemolytic disease and antiphospholipid antibodies: results from a prospective, case-control study. Haematologica 2005; 90 (05) 711-713
    PubMedGoogle Scholar
  • 13 Baek S-W, Lee M-W, Ryu H-W. et al. Clinical features and outcomes of autoimmune hemolytic anemia: a retrospective analysis of 32 cases. Korean J Hematol 2011; 46 (02) 111-117
    CrossrefPubMedGoogle Scholar
  • 14 Roumier M, Loustau V, Guillaud C. et al. Characteristics and outcome of warm autoimmune hemolytic anemia in adults: new insights based on a single-center experience with 60 patients. Am J Hematol 2014; 89 (09) E150-E155
    CrossrefPubMedGoogle Scholar
  • 15 Barcellini W, Fattizzo B, Zaninoni A. et al. Clinical heterogeneity and predictors of outcome in primary autoimmune hemolytic anemia: a GIMEMA study of 308 patients. Blood 2014; 124 (19) 2930-2936
    CrossrefPubMedGoogle Scholar
  • 16 Lecouffe-Desprets M, Néel A, Graveleau J. et al. Venous thromboembolism related to warm autoimmune hemolytic anemia: a case-control study. Autoimmun Rev 2015; 14 (11) 1023-1028
    CrossrefPubMedGoogle Scholar
  • 17 Audia S, Bach B, Samson M. et al. Venous thromboembolic events during warm autoimmune hemolytic anemia. PLoS One 2018; 13 (11) e0207218
    CrossrefPubMedGoogle Scholar
  • 18 Barbar S, Noventa F, Rossetto V. et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua prediction score. J Thromb Haemost 2010; 8 (11) 2450-2457
    CrossrefPubMedGoogle Scholar
  • 19 Cappellini MD. Coagulation in the pathophysiology of hemolytic anemias. Hematology (Am Soc Hematol Educ Program) 2007; 74–78: 74-78
    CrossrefPubMedGoogle Scholar
  • 20 Camus SM, De Moraes JA, Bonnin P. et al. Circulating cell membrane microparticles transfer heme to endothelial cells and trigger vasoocclusions in sickle cell disease. Blood 2015; 125 (24) 3805-3814
    CrossrefPubMedGoogle Scholar
  • 21 Helms CC, Marvel M, Zhao W. et al. Mechanisms of hemolysis-associated platelet activation. J Thromb Haemost 2013; 11 (12) 2148-2154
    CrossrefPubMedGoogle Scholar
  • 22 Rother RP, Bell L, Hillmen P, Gladwin MT. The clinical sequelae of intravascular hemolysis and extracellular plasma hemoglobin: a novel mechanism of human disease. JAMA 2005; 293 (13) 1653-1662
    CrossrefPubMedGoogle Scholar
  • 23 Chen G, Zhang D, Fuchs TA, Manwani D, Wagner DD, Frenette PS. Heme-induced neutrophil extracellular traps contribute to the pathogenesis of sickle cell disease. Blood 2014; 123 (24) 3818-3827
    CrossrefPubMedGoogle Scholar
  • 24 Weidmann H, Heikaus L, Long AT, Naudin C, Schlüter H, Renné T. The plasma contact system, a protease cascade at the nexus of inflammation, coagulation and immunity. Biochim Biophys Acta Mol Cell Res 2017; 1864 (11 Pt B): 2118-2127
    CrossrefPubMedGoogle Scholar
  • 25 Johannesdottir SA, Horváth-Puhó E, Dekkers OM. et al. Use of glucocorticoids and risk of venous thromboembolism: a nationwide population-based case-control study. JAMA Intern Med 2013; 173 (09) 743-752
    CrossrefPubMedGoogle Scholar
  • 26 Heit JA. Cardiovascular endocrinology: risk of venous thromboembolism with glucocorticoids. Nat Rev Endocrinol 2013; 9 (07) 387-388
    CrossrefPubMedGoogle Scholar
  • 27 van Zaane B, Nur E, Squizzato A. et al. Systematic review on the effect of glucocorticoid use on procoagulant, anti-coagulant and fibrinolytic factors. J Thromb Haemost 2010; 8 (11) 2483-2493
    CrossrefPubMedGoogle Scholar
  • 28 Gremmel T, Fedrizzi S, Weigel G, Eichelberger B, Panzer S. Underlying mechanism and specific prevention of hemolysis-induced platelet activation. Platelets 2017; 28 (06) 555-559
    CrossrefPubMedGoogle Scholar
  • 29 Nickel KF, Long AT, Fuchs TA, Butler LM, Renné T. Factor XII as a therapeutic target in thromboembolic and inflammatory diseases. Arterioscler Thromb Vasc Biol 2017; 37 (01) 13-20
    CrossrefPubMedGoogle Scholar