Clinical Presentation and Treatment Outcomes in Paediatric Autoimmune Hemolytic Anemia: A Case Series Analysis

Abstract

Background: Autoimmune hemolytic anemia (AIHA) is an acquired disorder characterized by immune-mediated destruction of red blood cells due to the production of autoantibodies against erythrocyte membrane antigens. In the pediatric population, the clinical spectrum is wide, ranging from mild, self-limiting illness to rapidly progressive and potentially life-threatening disease. Early identification, timely starting of therapy, and active monitoring are essential for optimal outcomes.

Purpose: The present case series aims to study the clinical presentation, course, and treatment outcomes of AIHA in children.

Methods: This case series was conducted over a period of two years (January 2024 to December 2025) in the Department of Paediatrics, Government Medical College, Palakkad. The present case series analysed the children admitted with characteristics of AIHA.

Results: We identified 4 children who presented with lethargy, severe pallor, jaundice, and hemoglobinuria. Direct Agglutination Test (DAT) was done for all 4 patients. DAT was positive in 3 patients but negative in 1 patient. Treatment with steroids was given to all 4 patients after ruling out alternate causes for DAT-negative haemolytic anemia. One child among the 4 cases had a fulminant course with cardiac decompensation but was managed successfully. One of our cases developed features of steroid toxicity, and we had to cut short the steroid course after 3 months. All children were followed up for one year, and none had any relapse.

Conclusion: Early diagnosis and early initiation of therapy have to be done in children with AIHA, and these children should be closely monitored for symptoms of steroid toxicity as they require a longer duration of steroid therapy.

  • Page Number : 93-99

  • Published Date : 2026-05-27

  • Keywords
    Autoimmune hemolytic anemia, Pediatric AIHA, Direct antiglobulin test, DAT-negative AIHA, Hemolysis, Corticosteroid therapy; Case series; Steroid toxicity

  • DOI Number
    10.15415/jmrh.2025.121011

  • Authors
    Sangeetha Prabhakaran, Chitra Sathiaseelan, Athira Thekkumpat Subramanian, Ajitha Mannattil, and Benshik Bal Thazhethacher Kandy

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