To Assess the Prevalence of Autoimmune Hemolytic Anemia (AIHA) Among Direct Antiglobulin Test (DAT) Positive Patients with a Focus on Serological Characterization in a Tertiary Care Hospital in Eastern India (T0161)

Introduction: Autoimmune Hemolytic Anemia (AIHA) is a rare yet significant hematological condition where autoantibodies target red blood cells, causing their destruction. The Direct Antiglobulin Test (DAT) plays a pivotal role in diagnosing AIHA. Understanding the serological profile of DAT-positive patients is essential for targeted management, particularly in regions like Eastern India, where data is limited.

Aims and Objectives:

Aim:

Conduct a prospective observational study to ascertain the prevalence and serological characterization of Autoimmune Hemolytic Anemia patients in an Eastern Indian tertiary care teaching center.

Objectives:

Primary Objective-To estimate the prevalence of AIHA amongst DAT positive patients with special reference to serological characterization.

Secondary Objectives-

To study the association between the strength of Direct Antiglobulin Test (DAT) and the clinical and Laboratory evidences of in vivo hemolysis.

Methods: A retrospective cross-sectional analysis was conducted over two years, including 200 DAT-positive patients attending a tertiary care hospital in Eastern India. Data were extracted from medical records, including clinical presentations, laboratory findings, and DAT results. Serological characterization involved the identification of autoantibodies, their thermal amplitude, and immunoglobulin class. Statistical analysis was performed to establish correlations.

Results: AIHA was confirmed in 40% of DAT-positive patients. Among these, 65% had warm autoantibodies, 25% had cold agglutinins, and 10% exhibited mixed-type antibodies. The mean hemoglobin level in AIHA patients was 7.5 g/dL, with common symptoms including fatigue, pallor, and jaundice. Severe cases required corticosteroid therapy or transfusions. Serological findings highlighted IgG dominance in warm AIHA and complement fixation in cold agglutinin disease.

Conclusion: AIHA constitutes a significant proportion of DAT-positive cases. Serological profiling enhances diagnostic precision and guides treatment strategies. Regional data provide a foundation for tailored healthcare interventions.

Keywords: Autoimmune hemolytic anemia, Direct Antiglobulin Test, DAT-positive, serological characterization, warm autoantibodies, Eastern India.