🩸 Section 513 · Warm Autoimmune Hemolytic Anemia (wAIHA)

Nelson Textbook of Pediatrics 22nd Edition | Warm autoimmune hemolytic anemia — most common AIHA in children (90% of cases). IgG autoantibodies, DAT positive (IgG ± C3), extravascular hemolysis (spleen). First-line: corticosteroids (prednisone 2 mg/kg/day). Second-line: rituximab. Splenectomy (after age 6 years). Associated with Evans syndrome (AIHA + ITP), viral infections, SLE, ALPS, CVID.

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📋 30 Clinical Scenarios — Warm Autoimmune Hemolytic Anemia

📇 High‑Yield Review Cards (wAIHA)

🩺 Clinical Recognition: Warm AIHA

Select a presentation for diagnostic clues and management.

📋 Stepwise Management of Warm AIHA

🔑 Key Principles — Nelson Section 513 (Warm AIHA)
• First-line: Prednisone 2 mg/kg/day (max 60 mg/day). Response in 2-4 weeks.
• Second-line: Rituximab (375 mg/m² weekly x 4) for steroid failure/relapse.
• Third-line: Splenectomy (after age 6-8 years) — vaccinate pre-op (pneumococcal, meningococcal, Hib).
• Evans syndrome: wAIHA + ITP ± neutropenia. Screen for ALPS, SLE, CVID.
• Transfusion: Use least incompatible RBCs if life-threatening (crossmatch difficult).

    ⚡ Reflex Prompts — Clinical Decisions in wAIHA

    📖 Summary: Warm Autoimmune Hemolytic Anemia — Nelson Section 513