Hematologic indices of autoimmune hemolytic anemia in adults: a retrospective study



  • Natchawan Tantithanarat 1Division of Hematology, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok
  • Supap Makruasi Division of Preventive Medicine, Ongkharak Hospital, Nakhon Nayok
  • Nisa Makruasi Division of Hematology, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok;


Autoimmune hemolytic anemia (AIHA), Reticulocyte count, Absolute reticulocyte count, Reticulocyte production index (RPI)


Background: Autoimmune hemolytic anemia (AIHA) is a rare condition of hemolytic anemia. Evaluation of hematologic indices such as hemoglobin (Hb), mean corpuscular volume (MCV), reticulocyte count (RC),  reticulocyte production index (RPI) and absolute reticulocyte count (ARC) could improve outcomes of treatment.

Objective: The study aimed to evaluate hematologic  indices such as Hb, MCV, RC, RPI, ARC in a patient with AIHA.

Materials and methods: Medical records were reviewed between 2011 and 2015 as a retrospective descriptive study. Data collections included personal demographics, disease characteristics, laboratory results, treatments, and treatment outcomes. Spearman’s correlation tests were used to correlate between RPI and factors. All data were analyzed using SPSS Software, Version 20, and p-value less than 0.05 was considered statistically significant.

Results: From 88 patients, the mean age was 60.17 (SD 18.92), and males were equal to the females. In all, 45 (51.1%), 18 (20.5%), 10 (11.4), 6 (6.8%), 6 (6.8%), and 3 (3.4%) patients received a diagnosis of idiopathic and infectious etiologies, systemic lupus erythematous (SLE), lymphoma, solid tumor and drug-associated AIHA, respectively. Most patients (92.1%) exhibited positive results of the direct Coombs test. Most (84.1%) patients had warm-type AIHA. The mean Hb, MCV, RPI and ARC at diagnosis were 7.27 g/dL (SD1.99), 83.61 fL (SD12.26), 0.82 (SD 0.68) and 79.11 x109/L (SD 58.20), respectively. RPI more than 2%, and ARC more than 100x109/L was found among 6 (6.8%), and 22 (25%) patients, respectively. RC positive correlated to RPI (r = 0.85, 95%CI: 0.75-0.91, p < 0.001), and ARC (r = 0.9, 95%CI: 0.83-0.94, p < 0.001). Moreover, RPI was positively correlated to systemic lupus erythematous (r = 0.235, p = 0.028, 95%CI: 0.023-0.396).

Conclusion: Idiopathic etiology was the common cause of AIHA. RPI and ARC were positive correlated to reticulocyte count among patients with AIHA, while RPI positively correlated to systemic lupus erythematous. 


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นิพนธ์ต้นฉบับ (Original article)