Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea

• DOI: 10.3345/cep.2024.02026
• Publication Date: 2025-04-16T02:46:46Z
• Authors: Young Dai Kwon; Eun Sun Jung; Yeon Jung Lim
• Keywords: Single Center; Center (category theory)

: Autoimmune hemolytic anemia (AIHA) is rare and characterized by with a positive direct antiglobulin test result after the exclusion of other causes. While adults often relapse within 1 year first-line steroid therapy, children generally respond well. However, current treatment approaches lack substantial evidence are primarily expert opinion-based. This study aimed to contribute our single-center experience pediatric AIHA guidelines. Between January 2012 June 2024, 475 were diagnosed anemia; them, 18 had immune anemia, including six neonatal alloimmune two who treated at centers, transient bone marrow suppression due viral infection. Thus, this retrospectively analyzed responses eight patients AIHA. The median age diagnosis was 5.2 (range, 2.3-11.8) years; 62.5% (5/8) male. Median hemoglobin (Hb) 6.3 3.4-9.5) g/dL, reticulocyte index 6.53% 1.64-22.07%), total bilirubin 2.75 0.98-7.23) mg/dL, lactate dehydrogenase 1662.0 790-2921) U/L. All haptoglobin levels <10 mg/dL. Treatments included steroids (8/8), red blood cell transfusions (5/8), intravenous immunoglobulins (2/8). Half steroid-treated received methylprednisolone for 1-5 days, while half oral prednisolone (median, 1.78 [range, 0.79-3.39] mg/kg/day). time age-adjusted normal Hb 16.5 9-22) days. Steroids administered 37.5 14-119) Excluding one patient later systemic lupus erythematosus, no relapses occurred during 3-19-month follow-up period. Patients showed relapse-free rapid hematological improvement sustained 2 months, suggesting that systematic feasible highlighting need multicenter trials establish standardized