Autoimmune Hemolytic Anemia (AIHA) - Warm autoantibodies (IgG) - Hematology

[@MedicosisPerfectionalis]

👨‍🏫 Cardiac Pharmacology Lectures: www.medicosisperfectionalis.com/

[@prafuloikhar6319]

Sir what is the treatment for this..my grandmother is suffering from this..plz guide me which specialist doctor I have to consult for this.

[@kharboze_asmr]

I have an exam for hematology Master's degree in 4 months and ur videos are really helpful to me even though i still need to read a lot of stuff i get the whole picture of every single topic with ur videos, i wish sth like this existed for other topics like immunology too!!. Anyway i really appreciate your work man. #respect

[@MedicosisPerfectionalis]

Thank you so much 😊 Good luck 🍀

[@DrogbaPT454]

In case people are wondering: The answer on the question in the end of video is Corticosteroids!; If it doesn't work then maybe splenectomy; In Children you can use Rituximab

[@leojanuszewski1019]

Rituximab is also used on adults. I have seen it be highly effective.

[@BeautifulHeart-x5q]

​@@leojanuszewski1019how many years are u okay after rituxan

[@nourahaljuwaisri9183]

I loved the video. Great job. Just wanted to correct one point (at 7:09) it is LEAST INCOMPATIBLE BLOOD, which means we cross match the available blood units and decide which one of them is least incompatible then we can transfuse, because we will never find a perfectly compatible unit in warm AIHA as the antibody is pan-agglutinin that react with all the reagents.

[@nourahaljuwaisri9183]

It is a Fatal mistake to intentionally give a patient an incompatible blood

[@user-dl8ox4lt3k]

I was confused a lot, but thank you guys you saved my future patients and my license.

[@thiskenyonslady]

THIS!!!

[@ahmedabd3191]

Thx for this lecture, Corticosteroid, because it is the first line treatment of warm AIHA.

[@ahmadal_shanqeety802]

Your style of summarising is perfect, as will as the drawing explaining which is the best way of studying for me, I can't study without any sort of drawing

[@MedicosisPerfectionalis]

You’re very similar to me!

[@moomoo6277]

i would like to thank you for making these videos. it really is a great help. you make the topics so much easier to understand

[@MedicosisPerfectionalis]

You're very welcome!

[@MrSmejg]

I love you video, the best at teaching for one to understand and retain info! Well done. By the way, did you speed up your presentation? As suggested by the comment in your previous video? I quite like the normal pace, made it easier to digest all the info.

[@mo7amed3babneh70]

its clear that you are on a hurry in comparison of your other videos , and the mice is not the usual mice i can tell . plz stick to your other mice and try to explain and repeat as you did in your previous videos . very helpful channel and great work

[@rosh6369]

Great video :) One issue ( that's not really an issue, just a visual error) I believe the IgG at 2:58 should be inverted as the IgG is recognising Rhesus antigens on the RBC, right? Not presenting the IgG itself (makes exposure of the Fc portion more understandable).

[@kunaljain197]

I couldn't stop laughing when he said "idiopathic" becoz we are idiots not knowing the pathology!😂😂 Great vid man as always!

[@MedicosisPerfectionalis]

Thank you ☺️

[@iamgopz]

0:40 Types of autoimmune disease 1:06 Autoantibody 1:44 Warm autoimmune hemolysis 2:43 Pathophysiology 3:05 Clinical Manifestation 3:41 Diagnosis 4:51 Treatment 6:28 Sample case

[@MedicosisPerfectionalis]

Thanks!

[@Dr.Harini_Sakthivel]

I am a AIHA Survivor

[@cxramelty242]

me too :)

[@juliamicha]

❤❤❤❤❤

[@professor9883]

bless you

[@Darieee]

Please fix your sound situation, on a proper set of speakers, this video is barely watchable. A quick fix would be to cut everything below 200Hz in your video editor ... and a better one would be improving the acoustics of the room :)

[@MedicosisPerfectionalis]

Hey, Thanks a lot for your feedback...This video was recorded in a library room and wasn’t so clear plus I increased its speed to 1.5X...Please take a look at my latest videos, I am sure the audio quality is much better, and if you have any suggestions, I am more than open to try...Thanks again!

[@gfm2450]

Great video! I understood what happens to the erythrocyte when it arrives to the spleen: the spleen macrophage endocite the erythrocyte by recognicing IgG from the erythrocyte... But what is the role of the complement (specially C3)?

[@MedicosisPerfectionalis]

Thanks for the question...I have explained this issue in this video. kzbin.info/www/bejne/nZTZqo2EqdKKpLM

[@katmeow95]

Thank you! Your videos are absolutely BRILLIANT!!

[@MedicosisPerfectionalis]

Thanks a million for your encouraging words!

[@luolulin5245]

Thanx for the revisiion. As a mbbs graduate who just diagnosed with autoimmune hemolytic anemia. Wish me good luck : )

[@MedicosisPerfectionalis]

I am so sorry 😐 Best of luck to you!

[@chanduz4658]

😞😞😞😞😓

[@BeautifulHeart-x5q]

What medicine did u take

[@VeerabadrenMylappan]

Great video. Thank you! 😊 Just one thing though - hemoglobin levels unit is in grams/ dL- not mg/dL

[@MedicosisPerfectionalis]

Oops 😬 Sorry

[@lonak1330]

Great explanation🔥♥️..please can you give me the link of this question ..i searched but i didn't find😔

[@deepvaishnav4506]

Audio quality is very poor. Couldn't understand some parts as it could not be heard.

[@mustafa-hd9625]

Why you give rituximab since it is type 2 hypersensitivity ? And what mean not specific antibody?

[@Majaschoice]

For the transfusion part, isnt it best to then transfuse O RhD negative blood?

[@yolyos15]

sorry but i still dont understand what you mean by antibodies have 2 choices either they "fix a complement" or "complement activation is weak" what do you mean by fix a complement??? fix it where?? i feel like im missing the context. :(

[@MedicosisPerfectionalis]

The complement proteins are normally floating in the blood. We need to fix them (onto the target cell or tissue) in order for destruction to take place. Hope it helps!

[@yolyos15]

@@MedicosisPerfectionalis thank you.

[@deepthimadabushi842]

I Actually got diagnosed with Evan's Syndrome a month ago... Thanks for the information. Really helpful as I'm on prednisone..

[@MedicosisPerfectionalis]

My pleasure! I am so sorry to hear about what you’re going through. How is your health now?

[@deepthimadabushi842]

@@MedicosisPerfectionalis My blood reports seem normal except for my lymphocyte count very low say 1-2 cells out of 13-20%. and my neutrophil count is off the charts.. Apart from that, I have spells of depression and anxiety.

[@MedicosisPerfectionalis]

I am so sorry 😐. Make sure to follow up with your doctor! And don’t give up!

[@deepthimadabushi842]

@@MedicosisPerfectionalis Sometimes I do feel like giving up... I do know mine is not genetically related but it is due to somatic mutation. Trying to avoid radiation as much as possible but kinda addicted to them... Distracting myself by doing more research on my condition if they are any support group where i can join and share my experience. :)

[@leojanuszewski1019]

@@deepthimadabushi842 Diagnosed with Evans myself this past summer. White cells were fine but was anemic and had undetectable platelet levels. Hospital, IVIG, prednisone, etc. A potential game changer for me has been Rituximab---completed a course of that in September and all cell levels steadily normal since them. There are a couple of E.S. online support groups on Facebook. Hope you are doing better!

[@published.research6624]

Thanks for the video. Out of curiosity, why is the haptoglobin low in extravascular hemolysis. Sounds like it would be low in 'intravascular' hemolysis

[@MedicosisPerfectionalis]

It can be low in either.

[@yinkus100]

okay, let me try to answer a question today . This patient obviously has signs of anaemia, hemolysis and overworking of the reticuloendotilear system, hmm.. what is the diagnosis? I'm thinking in a 70year old man, possibly warm immume hemolytic disease, so I'll give corticosteriod. I have a question thou, why is the white blood cell count that elevated? Also, I'll rather do further tests. Please, medicosis, shed more light. Thanks.

[@MedicosisPerfectionalis]

Steroids is the correct answer. WBCs could be elevated due to many factors including stress.

[@yinkus100]

@@MedicosisPerfectionalis l know the answer to my question now, its leukemoid reaction

[@anishareddysingireddy1799]

Great job doctor awesome

[@MedicosisPerfectionalis]

Many many thanks!

[@arianks7668]

Great video as always. I'm not sure if you've already addressed this: antibodies should "grab" the RBCs from the variable region, not the constant region (at 2:59, for example).

[@mariamughal6697]

Ur voice is awesome

[@shahabuddin6149]

Really great lecture thanks unlimited

[@MedicosisPerfectionalis]

My pleasure 😇

[@Fizz826]

Last time I had aiha it was triggered by the MMR vaccine in 1996 when I was 22. Now that the COVID vaccine is coming out, can I take it?

[@jamshaidkhan2971]

I have a question; If we see spherocytes on peripheral film, then why is MCV high because I was under the impression that spheres have less volume then biconcave RBCs?

[@lebocarolinenkosi5533]

I guess the macrocytes(due to increased bone marrow activity) are more than the spherocytes in number🤷‍♀️

[@drpepper7801]

Spherocytes are larger...

[@bibimaryam7315]

Mcv is higher because reticulocyte count os higher which have larger volume thn the RBCs

[@ELSEDEM]

Great video..but didn't hear much because you were speaking too fast... Nice summary though

[@amirasaied5755]

U talk rapidly here than ur usual, I like ur usual tone😢

[@MedicosisPerfectionalis]

Don’t worry...It’s only this video

[@ilovebeinagirl]

Slow it down to 0.75 speed

[@argumentumadbaculum]

Corticosteroids, will it not mask the diagnosis of underlying lymphoma

[@juliennegrace4155]

Corticoid then rituximab. ..

[@MedicosisPerfectionalis]

Perfect 👌

[@sonalibhat5149]

But if it is AIHA why are platelet count and wbc increased?

[@salilkulkarniindia]

@@sonalibhat5149 Immune response ----> WBC count is increased

[@mirabadrina3863]

Keep up the great work!

[@MedicosisPerfectionalis]

Thanks a million!

[@lunaahmed8989]

Q please :haptoglopin is low because there is too much free hemoglbin in the blood flow to bound up with? ..or because of phagocyts ..it is in RBC?? many thanks 🌹🌹

[@MedicosisPerfectionalis]

It’s not in that red blood cells. It was a mistake from me. I’ve made a separate video on haptoglobin to discuss that: kzbin.info/www/bejne/h4PCmZaJpNxnhas

[@lunaahmed8989]

@@MedicosisPerfectionalis thanks alot ..I can't study hematology without your vedios ....you're great👌

[@MedicosisPerfectionalis]

My pleasure! Good luck with everything!

[@neroetal]

was equally confused about the same,,,, otherwise great progress bro

[@ujjawalbhaidiya7991]

Great sir...... thank you very much I have a question sir .... What is the source of the material I mean the reference...I you answered this it will be a great help sir

[@MedicosisPerfectionalis]

Harrison's, Davidson's, Goljan, and Medstudy

[@kyau124]

I've tried Rituximab, it didn't work for me. I have been on and off Corticosteroids now as I'm reluctant to Splenectomy. What is EPO? Blood transfusion? Just trying to find an alternative way to get well.

[@MedicosisPerfectionalis]

EPO is a hormone that stimulates the bone marrow to secrete more RBCs.

[@ericac2355]

Is Haptoglobin affected by extravascular hemolysis? I thought it would only be affected by intravascular? Thanks for the video!

[@MedicosisPerfectionalis]

Great question...Haptoglobin can be low in either type of hemolysis, especially with intravascular...I have explained this in my video: Intravascular Vs Extravascular Hemolytic Anemia kzbin.info/www/bejne/iHqkkKlqhbGco8U

[@rubymusqan3792]

wonderful lecture!! but i have one doubt on the treatment of patients with blood transfusion of incompatible type. if the antibodies are nonspecific, then they might as well react with the transfused blood. should i understand it more differently? can u explain?

[@MedicosisPerfectionalis]

Can you elaborate please?

[@rubymusqan3792]

@@MedicosisPerfectionalis why don't the antibodies react with the incompatible blood type completely? and what does it mean if you say that the antibodies are nonspecific?

[@alihasanalrashid3137]

Very nice video 👍🏻 thank u

[@MedicosisPerfectionalis]

My pleasure 😇

[@Roxy__12]

So good thank you!!!

[@MedicosisPerfectionalis]

My pleasure 😇

[@ahmadaljazeeri9287]

Thank you for making these videos 😄

[@MedicosisPerfectionalis]

My pleasure 😇

[@Verbena_Vetiver]

great video!

[@MedicosisPerfectionalis]

Thank you so much...Glad you liked it!

[@Ibrahim-0433]

at 5:50 mins what will happen to the rest of 50% of the blood unit in the body they are incompatible to the body?

[@MAli-hd4sy]

Very very good

[@MedicosisPerfectionalis]

Thanks 🙏

[@danthorngren1826]

Corticosteroids? Your videos are excellent, thank you much!!

[@MedicosisPerfectionalis]

Dan Thorngren you’re correct, answer is corticosteroids...Thanks!

[@cindyhansen7681]

What if you have both Warm and Cold?

[@noorhamed4690]

Aswesome....Now I was fascinated autoimmune H.A🤗

[@MedicosisPerfectionalis]

Thanks :)

[@swethagandikota6351]

I have AIHA disorder and suffering with hypothyroidism in which tsh is fluctuating.what can be done.now my condition is normal

[@MedicosisPerfectionalis]

I don't know 🤷‍♂️ Please talk to your doctor

[@babariqbal413]

If we transfused blood in pateint, can we go for comb test or not ?

[@rafaelvieira4267]

good question

[@bushraquadri9532]

Can u tell me the DIAGNOSIS?type of hemolytic anaemia?

[@MedicosisPerfectionalis]

Regarding what?

[@lisahineslh]

This is happening to me. They want me on Rituxan. No one ever did the stool guac test though? What is the purpose for that. Also, have you ever heard of way to attack this holistically?

[@MedicosisPerfectionalis]

The stool guaiac test is to rule out bleeding from the gastrointestinal tract...I don’t believe in holistic medicine, I only believe in evidence-based medicine; the one with the randomized clinical trials and meta-analyses. I wish you the best!

[@lisahineslh]

@@MedicosisPerfectionalis Oh, they did rule out gastrointestinal bleeding. Thank you for your response.

[@MedicosisPerfectionalis]

You’re welcome 😊

[@rogeryin5777]

I think the clinical scenario look 2nd AIHA due to chronic lymphocytic leukemia, the Retic count is 8% indicate there is hemolysis, the CLL is mostly affected by B-cell. since Rituximab is specific for CD 20 of B-cell, therefore, I choose A. please tell us the correct answer.

[@MedicosisPerfectionalis]

Thanks for your answer...Although it’s not totally incorrect, I prefer “corticosteroids” as next step for the autoimmune hemolytic anemia...Then you can try Rituximab (for the hemolytic anemia as well as CLL)...Thanks!

[@rogeryin5777]

I agree, thanks for your reply, keep up the good stuff. your video is very informative.

[@MedicosisPerfectionalis]

Of course...and please try to share these videos with others...It really helps...thanks dear :)

[@nabilahnurulislami8292]

is the answer corticosteroid?

[@neroetal]

nice presentation

[@MedicosisPerfectionalis]

Thanks 🙏

[@hindhind466]

9. What is an iatrogenic cause of AIHA?

[@MAli-hd4sy]

Great thanx

[@MedicosisPerfectionalis]

My pleasure 😇

[@co-asst_ayubettyhutagaol4932]

thanks you sir!

[@MedicosisPerfectionalis]

My pleasure 😇

[@leojanuszewski1019]

Are you familiar with any books on Evans Syndrome? Or a textbook chapter on ES? Thank you!

[@MedicosisPerfectionalis]

No! Try UpToDate website (you might have to pay for subscription).

[@leojanuszewski1019]

@@MedicosisPerfectionalis Thanks for the tip. 👍

[@MedicosisPerfectionalis]

You’re welcome 😇

[@sohailasghar8471]

Splenectomy bcz infection is not going to settle even with antibiotics bcz of continuous extravascular haemolysis .

[@MedicosisPerfectionalis]

I will choose steroids first...Think cheap! The diagnosis is CLL causing autoimmune hemolytic anemia.

[@sohailasghar8471]

@@MedicosisPerfectionalis Thanks for correcting me .

[@MedicosisPerfectionalis]

No worries...You’re doing fine!

[@bhaveshgarg8142]

how am i ever gonna find the answer to that qn on your facebook page . it has like a 1000s of post and this post will be 3 years before

[@MedicosisPerfectionalis]

I am sorry about that! Just email me your questions, and I will answer them for you: [e-mail]

[@andriqukamanahan3208]

I would say corticosteroids is the next step

[@citlalie9791]

I have sjogrens and I have this type of anemia

[@MedicosisPerfectionalis]

I am sorry to hear that!

[@toufiqenam9516]

Next time pls try to explain the lines by your own method.because we are here to clear the concept.im text book we all have this info.

[@MedicosisPerfectionalis]

I don’t quite understand...Can you explain more, please?

[@sofiaahmed3872]

Great

[@MedicosisPerfectionalis]

Thank you so much 😊

[@cindyhansen7681]

What’s your take on getting Covid vaccine with both Warm and Cold antibodies?

[@anishareddysingireddy1799]

Doctor please guide, me for pdfs

[@MedicosisPerfectionalis]

Here: www.medicosisperfectionalis.com/products/illustrated-notes-pdfs/

[@ganeshchidambar3299]

this video slightly faster than others :) maybe u drank some strong coffee :)

[@MedicosisPerfectionalis]

Hehe 🙃

[@Reemessi1]

ههههههههههههههههههههههههههههه

[@shikhavats7898]

I feel like this either medicosis perfectionalis 😑isn't well 🙄r u well or someone else is here 🧐

[@nurfasihah1709]

the video is so great. but the way you explain is not as good as other videos in your channel.

[@eghonghonomonbude4643]

Please, what's the name of ur KZbin page?

[@MedicosisPerfectionalis]

Medicosis Perfectionalis

[@eghonghonomonbude4643]

@@MedicosisPerfectionalis thanks..... Ooopss, I meant Facebook page🙏

[@sipofmedicine7407]

@@MedicosisPerfectionalis LOL😂😂❤️

[@Sarah-fy2vf]

Are you ok here ? I like your funny soul 💙 Thanks alot 🌹

[@MedicosisPerfectionalis]

I am doing great 👍

[@TheX7mood]

Weeeeellllllllll explained ❤️❤️

[@MedicosisPerfectionalis]

Thank you so much ☺️

[@drtonyissac9297]

Bro what happened to your sound

[@hardik7942]

The primary - idiopathic thing. House MD anyone ?

[@MedicosisPerfectionalis]

I don’t understand.

[@hardik7942]

@@MedicosisPerfectionalis House MD is a drama series based on clinical cases and team of doctors working together. " Idiopathic - we are idiots because we don't know the cause " exact same dialogue in one of the episodes.

[@MedicosisPerfectionalis]

Hahahaha 😅

[@holzeinn4834]

It's never lupus!

[@alaaadammohammed2426]

No 1 I guess am I right?!!

[@هانيمحمد-ك1ب]

Incompatible blood may kill the patient

[@MedicosisPerfectionalis]

That's right.

[@1st.marvelvsdc]

Video is fast

[@MedicosisPerfectionalis]

True...I made a mistake in that video that I never repeated again.

[@rafalaliaseeb8553]

corticosteroid but and i don't why 😂👌🏻

[@MedicosisPerfectionalis]

Haha 😂

[@tahiransari3917]

Corticosteroid

[@dewiarianna]

ur speaking is too fast :(

[@A6Bnito]

Corticosteroids

[@sabakhan2016]

U speak very fast

[@Yaseen1051]

corticosteroid i guess

[@DocAmikable]

Splenectomy

[@BretHitman]

Transfuse

[@lifeandsciencecomicsfacthi1916]

that is a great effort I really appreciate that may you send me your Facebook account

[@mrstmx99]

cause we are idiots :D

[@MedicosisPerfectionalis]

Haha 😂

[@nurfasihah1709]

next time please give your lecture with your heart. you seems so lazy to explain. anyway thank you for everything hope you improve