Araştırma Makalesi
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Evaluation of Patients Diagnosed with Autoimmune Hemolytic Anemia in Terms of Etiology and Treatment: a single center experience

Yıl 2026, Cilt: 48 Sayı: 2, 277 - 285, 11.02.2026
https://doi.org/10.20515/otd.1832577
https://izlik.org/JA74ZB96YW

Öz

This study aimed to evaluate the etiological factors, clinical and laboratory characteristics, and treatment responses of patients diagnosed with autoimmune hemolytic anemia (AIHA) at Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine. In this retrospective study, data of 91 patients diagnosed with AIHA between January 1, 2017, and January 1, 2025, were analyzed. Demographic features, serological subtypes, comorbidities, laboratory values, treatment approaches, and clinical outcomes were assessed using hospital records. Of the patients, 63.7% were female, with a median age of 57.3±18.5 years. The distribution of serological subtypes was: warm-type AIHA 46.2%, cold agglutinin disease (CAD) 17,5%, and mixed-type AIHA 36.3%. Secondary AIHA was present in 62.6% of patients, with the most common causes being lymphomas (13.2%), systemic lupus erythematosus (11%), and chronic lymphocytic leukemia (11%). The relapse rate was 19.8%, most frequently observed in mixed-type AIHA. Thromboembolic events occurred in 11% of patients, especially in older individuals. Among patients with primary AIHA, 61.8% received corticosteroids as first-line therapy, with a complete response achieved in 82.4%. Rituximab was administered as second-line therapy in 5 patients, yielding a 60% response rate. AIHA is a heterogeneous disorder in which identifying secondary causes and serological subtypes plays a critical role in diagnosis and treatment. While warm type AIHA is the most common form, mixed-type cases tend to be more resistant to treatment. In conclusion, effective therapy and close monitoring are essential in reducing relapse and thromboembolic complications.

Kaynakça

  • 1. Barcellini, W., New Insights in the Pathogenesis of Autoimmune Hemolytic Anemia. Transfus Med Hemother, 2015. 42(5): p. 287-93.
  • 2. Semple, J.W. and J. Freedman, Autoimmune pathogenesis and autoimmune hemolytic anemia. Semin Hematol, 2005. 42(3): p. 122-30.
  • 3. Berentsen, S. and W. Barcellini, Autoimmune Hemolytic Anemias. N Engl J Med, 2021. 385(15): p. 1407-1419.
  • 4. Petz, L.D. and G. Garratty, Immune hemolytic anemias. (No Title), 2004.
  • 5. Murakhovskaya, I., Rituximab Use in Warm and Cold Autoimmune Hemolytic Anemia. J Clin Med, 2020. 9(12).
  • 6. Hansen, D.L., et al., Increasing Incidence and Prevalence of Acquired Hemolytic Anemias in Denmark, 1980-2016. Clin Epidemiol, 2020. 12: p. 497508.
  • 7. Fattizzo, B. and W. Barcellini, Autoimmune hemolytic anemia: causes and consequences. Expert Rev Clin Immunol, 2022. 18(7): p. 731-745.
  • 8. Barcellini, W., J. Giannotta, and B. Fattizzo, Autoimmune hemolytic anemia in adults: primary risk factors and diagnostic procedures. Expert Rev Hematol, 2020. 13(6): p. 585-597.
  • 9. Berentsen, S., et al., Novel insights into the treatment of complement-mediated hemolytic anemias. Ther Adv Hematol, 2019. 10: p. 2040620719873321.
  • 10. Barcellini, W. and B. Fattizzo, Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia. Dis Markers, 2015. 2015: p. 635670.
  • 11. Jäger, U., et al., Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting. Blood Rev, 2020. 41: p. 100648.
  • 12. Barros, M.M., M.A. Blajchman, and J.O. Bordin, Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and the treatment. Transfus Med Rev, 2010. 24(3): p. 195-210.
  • 13. Roumier, M., 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(9): p. E150-5.
  • 14. Michel, M., et al., The spectrum of Evans syndrome in adults: new insight into the disease based on the analysis of 68 cases. Blood, 2009. 114(15): p. 3167- 72.
  • 15. Norton, A. and I. Roberts, Management of Evans syndrome. Br J Haematol, 2006. 132(2): p. 125-37.
  • 16. Zanella, A. and W. Barcellini, Treatment of autoimmune hemolytic anemias. Haematologica, 2014. 99(10): p. 1547-54.
  • 17. Berentsen, S., et al., Cold agglutinin disease revisited: a multinational, observational study of 232 patients. Blood, 2020. 136(4): p. 480-488.
  • 18. Hill, Q.A., et al., The diagnosis and management of primary autoimmune haemolytic anaemia. Br J Haematol, 2017. 176(3): p. 395-411.
  • 19. Schär, D.T., et al., Thromboembolic complications in autoimmune hemolytic anemia: Retrospective study. Eur J Haematol, 2022. 108(1): p. 45-51.
  • 20. Naithani, R., et al., Autoimmune hemolytic anemia in India: clinicohematological spectrum of 79 cases. Hematology, 2006. 11(1): p. 73-6.
  • 21. Barcellini, W., Current treatment strategies in autoimmune hemolytic disorders. Expert Rev Hematol, 2015. 8(5): p. 681-91.
  • 22. Zecca, M., et al., Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood, 2003. 101(10): p. 3857-61.
  • 23. Barcellini, W. and B. Fattizzo, The Changing Landscape of Autoimmune Hemolytic Anemia. Front Immunol, 2020. 11: p. 946.

Otoimmün Hemolitik Anemi Tanılı Hastalarımızın Etiyoloji ve Tedavi Açısından Değerlendirilmesi: Tek Merkez Deneyimi

Yıl 2026, Cilt: 48 Sayı: 2, 277 - 285, 11.02.2026
https://doi.org/10.20515/otd.1832577
https://izlik.org/JA74ZB96YW

Öz

Bu çalışmada, Eskişehir Osmangazi Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı’nda takip edilen otoimmün hemolitik anemi (OİHA) tanılı hastaların etiyolojik nedenleri, klinik ve laboratuvar özellikleri ile tedavi yanıtları değerlendirilerek literatüre katkı sağlanması amaçlanmıştır. Çalışma, 1 Ocak 2017- 1 Ocak 2025 tarihleri arasında OİHA tanısı konulmuş 91 hastanın retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Veriler hasta dosyalarından elde edilmiş; demografik bilgiler, serolojik alt tip dağılımları, komorbiditeler, laboratuvar değerleri, tedavi protokolleri ve klinik sonuçlar analiz edilmiştir. Hastaların %63,7’si kadın olup, medyan yaş 57,3±18,5 yıl olarak saptanmıştır. Serolojik alt tip dağılımı sıcak tip OİHA %46,2, soğuk aglütinin hastalığı (SAH) %17,5 ve karma tip OİHA %36,3 şeklindedir. Hastaların %62,6’sı sekonder OİHA olup, en sık eityolojik nedenler lenfomalar (%13,2), sistemik lupus eritematozus (SLE) (%11) ve kronik lenfositik lösemi (KLL) (%11) olarak belirlenmiştir. Relaps oranı %19,8 olup, en sık karma tip OİHA’da görülmüştür. Tromboembolik olay oranı %11 olup, özellikle ileri yaş hastalarda daha sık saptanmıştır. Primer OİHA hastalarının %61,8’i birinci basamakta steroid tedavisi almış, %82,4’ünde tam yanıt elde edilmiştir. İkinci basamakta rituksimab kullanılan hastalarda ise %60’lık yanıt oranı gözlenmiştir. OİHA heterojen yapıda bir hastalık olup, özellikle sekonder nedenlerin ve serolojik alt tiplerin belirlenmesi, tanı ve tedavi sürecinde büyük önem taşımaktadır. Sıcak tip OİHA en sık görülen alt tip olmakla birlikte, karma tip olgular daha dirençli seyretmektedir. Etkin tedavi ve yakın izlem, relaps ve tromboembolik olayları azaltmada kritik rol oynamaktadır.

Kaynakça

  • 1. Barcellini, W., New Insights in the Pathogenesis of Autoimmune Hemolytic Anemia. Transfus Med Hemother, 2015. 42(5): p. 287-93.
  • 2. Semple, J.W. and J. Freedman, Autoimmune pathogenesis and autoimmune hemolytic anemia. Semin Hematol, 2005. 42(3): p. 122-30.
  • 3. Berentsen, S. and W. Barcellini, Autoimmune Hemolytic Anemias. N Engl J Med, 2021. 385(15): p. 1407-1419.
  • 4. Petz, L.D. and G. Garratty, Immune hemolytic anemias. (No Title), 2004.
  • 5. Murakhovskaya, I., Rituximab Use in Warm and Cold Autoimmune Hemolytic Anemia. J Clin Med, 2020. 9(12).
  • 6. Hansen, D.L., et al., Increasing Incidence and Prevalence of Acquired Hemolytic Anemias in Denmark, 1980-2016. Clin Epidemiol, 2020. 12: p. 497508.
  • 7. Fattizzo, B. and W. Barcellini, Autoimmune hemolytic anemia: causes and consequences. Expert Rev Clin Immunol, 2022. 18(7): p. 731-745.
  • 8. Barcellini, W., J. Giannotta, and B. Fattizzo, Autoimmune hemolytic anemia in adults: primary risk factors and diagnostic procedures. Expert Rev Hematol, 2020. 13(6): p. 585-597.
  • 9. Berentsen, S., et al., Novel insights into the treatment of complement-mediated hemolytic anemias. Ther Adv Hematol, 2019. 10: p. 2040620719873321.
  • 10. Barcellini, W. and B. Fattizzo, Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia. Dis Markers, 2015. 2015: p. 635670.
  • 11. Jäger, U., et al., Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting. Blood Rev, 2020. 41: p. 100648.
  • 12. Barros, M.M., M.A. Blajchman, and J.O. Bordin, Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and the treatment. Transfus Med Rev, 2010. 24(3): p. 195-210.
  • 13. Roumier, M., 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(9): p. E150-5.
  • 14. Michel, M., et al., The spectrum of Evans syndrome in adults: new insight into the disease based on the analysis of 68 cases. Blood, 2009. 114(15): p. 3167- 72.
  • 15. Norton, A. and I. Roberts, Management of Evans syndrome. Br J Haematol, 2006. 132(2): p. 125-37.
  • 16. Zanella, A. and W. Barcellini, Treatment of autoimmune hemolytic anemias. Haematologica, 2014. 99(10): p. 1547-54.
  • 17. Berentsen, S., et al., Cold agglutinin disease revisited: a multinational, observational study of 232 patients. Blood, 2020. 136(4): p. 480-488.
  • 18. Hill, Q.A., et al., The diagnosis and management of primary autoimmune haemolytic anaemia. Br J Haematol, 2017. 176(3): p. 395-411.
  • 19. Schär, D.T., et al., Thromboembolic complications in autoimmune hemolytic anemia: Retrospective study. Eur J Haematol, 2022. 108(1): p. 45-51.
  • 20. Naithani, R., et al., Autoimmune hemolytic anemia in India: clinicohematological spectrum of 79 cases. Hematology, 2006. 11(1): p. 73-6.
  • 21. Barcellini, W., Current treatment strategies in autoimmune hemolytic disorders. Expert Rev Hematol, 2015. 8(5): p. 681-91.
  • 22. Zecca, M., et al., Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood, 2003. 101(10): p. 3857-61.
  • 23. Barcellini, W. and B. Fattizzo, The Changing Landscape of Autoimmune Hemolytic Anemia. Front Immunol, 2020. 11: p. 946.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Epidemiyoloji (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Caner Yazıcı Bu kişi benim 0009-0005-7716-3179

Hava Üsküdar Teke 0000-0002-4434-4580

Gönderilme Tarihi 30 Kasım 2025
Kabul Tarihi 5 Ocak 2026
Yayımlanma Tarihi 11 Şubat 2026
DOI https://doi.org/10.20515/otd.1832577
IZ https://izlik.org/JA74ZB96YW
Yayımlandığı Sayı Yıl 2026 Cilt: 48 Sayı: 2

Kaynak Göster

Vancouver 1.Yazıcı C, Üsküdar Teke H. Otoimmün Hemolitik Anemi Tanılı Hastalarımızın Etiyoloji ve Tedavi Açısından Değerlendirilmesi: Tek Merkez Deneyimi. Osmangazi Tıp Dergisi [Internet]. 01 Şubat 2026;48(2):277-85. Erişim adresi: https://izlik.org/JA74ZB96YW


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