References
Immune-mediated haemolytic anaemia, part 1: pathophysiology and diagnosis
Abstract
Immune-mediated haemolytic anaemia is a relatively common condition in dogs, and uncommonly encountered in cats. Prompt and appropriate recognition is paramount to optimal management and improved health outcomes. Currently, no single test has been proven to be definitively diagnostic for immune-mediated haemolytic anaemia. Therefore, a logical and thorough approach is key to achieving an accurate diagnosis.
Immune-mediated haemolytic anaemia (IMHA) is a frequent cause of anaemia and is one of the most common autoimmune conditions diagnosed in dogs (Goggs et al, 2015). In cats, IMHA is an uncommon cause of anaemia (Swann et al, 2016), with disorders such as infections and neoplasia appearing to be more prevalent causes (Korman et al, 2013). However, IMHA in cats can still result in a severe and life-threatening condition (Swann et al, 2016).
Generally, IMHA has been categorised into primary (idiopathic) or secondary. The American College of Veterinary Internal Medicine (ACVIM) consensus statement on the diagnosis of IMHA in dogs and cats (Garden et al, 2019) proposed the designation of ‘non-associative’ for ‘primary’ and ‘associative’ for ‘secondary’ IMHA. The rationale behind this suggested terminology is that the term ‘primary’ would imply all triggers to have been definitively ruled out, while ‘secondary’ would indicate a proven causality between concurrent pathologies. In practice many cases may be ambiguous, so the term ‘associative’ describes cases of IMHA in which one or more comorbidities are identified, whereas ‘non-associative’ implies that no other disease has been identified with the diagnostic tests used.
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