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Question
I would like to know how can i mange a case of autoimmune hemolytic anemia (agglutinin cold antibodies), one year old, her hemoglobin 7gm%,her blood group AB+ which isn`t compatible with the same blood groups in our bank.
Answer
1. The primary cause for AIHA needs to be ascertained. Treating the primary cause may relieve the child of the hemolytic process. Cold aglutinin hemolytic anemia is usually secondary to some infection.

2. If the hemoglobin is 7 gm and stable, transfusion may not be indicated.

3. If the hemoglobin shows a dropping trend with levels falling below 5 gms then I would transfuse under cover of steroids with the least compatible blood unit. There is bound to be difficulty in cross matching, hence we use the least compatible unit on cross matching.

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