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2015 ; 42
(5
): 303-10
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Role of Complement in Autoimmune Hemolytic Anemia
#MMPMID26696798
Berentsen S
Transfus Med Hemother
2015[Sep]; 42
(5
): 303-10
PMID26696798
show ga
The classification of autoimmune hemolytic anemias and the complement system are
reviewed. In autoimmune hemolytic anemia of the warm antibody type,
complement-mediated cell lysis is clinically relevant in a proportion of the
patients but is hardly essential for hemolysis in most patients. Cold
antibody-mediated autoimmune hemolytic anemias (primary cold agglutinin disease,
secondary cold agglutinin syndrome and paroxysmal cold hemoglobinuria) are
entirely complement-mediated disorders. In cold agglutinin disease, efficient
therapies have been developed in order to target the pathogenic B-cell clone, but
complement modulation remains promising in some clinical situations. No
established therapy exists for secondary cold agglutinin syndrome and paroxysmal
cold hemoglobinuria, and the possibility of therapeutic complement inhibition is
interesting. Currently, complement modulation is not clinically documented in any
autoimmune hemolytic anemia. The most relevant candidate drugs and possible
target levels of action are discussed.