&lt;p&gt;Increasing Incidence and Prevalence of Acquired Hemolytic Anemias in Denmark, 1980–2016&lt;/p&gt;

Hansen, Dennis Lund; Möller, Sören; Andersen, Kjeld; Garcı́a-Dorado, David; Frederiksen, Henrik

doi:10.2147/clep.s250250

Cited by 32 publications

(59 citation statements)

References 36 publications

(69 reference statements)

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“…Epidemiology and risk factors for AIHA development It is currently estimated that the incidence of AIHA is 1.77 cases per 100,000 per year [18], of which wAIHA is the most common form and accounts for about 2/3 of cases [19]. CAD is the second most common, accounting for approximately 15-20% of AIHA cases [20].…”

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confidence: 99%

Autoimmune hemolytic anemia: current knowledge and perspectives

et al. 2020

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Autoimmune hemolytic anemia (AIHA) is an acquired, heterogeneous group of diseases which includes warm AIHA, cold agglutinin disease (CAD), mixed AIHA, paroxysmal cold hemoglobinuria and atypical AIHA. Currently CAD is defined as a chronic, clonal lymphoproliferative disorder, while the presence of cold agglutinins underlying other diseases is known as cold agglutinin syndrome. AIHA is mediated by autoantibodies directed against red blood cells (RBCs) causing premature erythrocyte destruction. The pathogenesis of AIHA is complex and still not fully understood. Recent studies indicate the involvement of T and B cell dysregulation, reduced CD4+ and CD25+ Tregs, increased clonal expansions of CD8 + T cells, imbalance of Th17/Tregs and Tfh/Tfr, and impaired lymphocyte apoptosis. Changes in some RBC membrane structures, under the influence of mechanical stimuli or oxidative stress, may promote autohemolysis. The clinical presentation and treatment of AIHA are influenced by many factors, including the type of AIHA, degree of hemolysis, underlying diseases, presence of concomitant comorbidities, bone marrow compensatory abilities and the presence of fibrosis and dyserthropoiesis. The main treatment for AIHA is based on the inhibition of autoantibody production by mono- or combination therapy using GKS and/or rituximab and, rarely, immunosuppressive drugs or immunomodulators. Reduction of erythrocyte destruction via splenectomy is currently the third line of treatment for warm AIHA. Supportive treatment including vitamin supplementation, recombinant erythropoietin, thrombosis prophylaxis and the prevention and treatment of infections is essential. New groups of drugs that inhibit immune responses at various levels are being developed intensively, including inhibition of antibody-mediated RBCs phagocytosis, inhibition of B cell and plasma cell frequency and activity, inhibition of IgG recycling, immunomodulation of T lymphocytes function, and complement cascade inhibition. Recent studies have brought about changes in classification and progress in understanding the pathogenesis and treatment of AIHA, although there are still many issues to be resolved, particularly concerning the impact of age-associated changes to immunity.

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confidence: 99%

Autoimmune hemolytic anemia: current knowledge and perspectives

et al. 2020

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“…Andrew Charlton 2 Tom Bullock 3 Edwin Massey 3 Anita Hill 1 Shubha Allard 4 Simon J. Stanworth 5,6,7…”

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confidence: 99%

“…Protection of telomeres 1 (POT1) is a component of the shelterin complex of six subunits encoded by adrenocortical dysplasia protein homologue (ACD; also known as TPP1), POT1, telomeric repeat binding factor 1 (TERF1), telomeric repeat binding factor 2 (TERF2), TERF1-interacting nuclear factor 2 (TINF2) and TERF2 interacting protein (TERF2IP), which binds to single-stranded telomeric DNA to regulate telomere elongation and integrity. 1 The telomerase and shelterin complexes play specific roles in telomere maintenance and prevention of activation of DNA damage response pathways at telomeres, by protecting single-stranded DNA (ssDNA) overhangs. 1 Conserved oligonucleotide/oligosaccharide-binding (OB) domains in POT1 recognise specific ssDNA motifs with high affinity and are required for POT1 function.…”

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confidence: 99%

“…1 The telomerase and shelterin complexes play specific roles in telomere maintenance and prevention of activation of DNA damage response pathways at telomeres, by protecting single-stranded DNA (ssDNA) overhangs. 1 Conserved oligonucleotide/oligosaccharide-binding (OB) domains in POT1 recognise specific ssDNA motifs with high affinity and are required for POT1 function. 1 Acquired and inherited variants in POT1 that alter these OB folds are associated with longer telomeres due to disruption of shelterin function.…”

Section: Conflicts Of Interestmentioning

confidence: 99%

“…Recent data on the incidence and prevalence figures for autoimmune haemolytic anaemia (AIHA) from the Danish national register are 1Á77/100,000 person-years and 17/ 100,000 persons. 1 Applied to the estimated mid-2019 United Kingdom (UK) population of 66,796,800, 2 this would translate to around 1200 cases/year and 11,000 affected individuals. Mortality directly attributed to AIHA and its treatment in 308 primary AIHA patients (median FU 33 months) has been estimated at 4%.…”

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Developing the evidence base for the management of autoimmune haemolytic anaemia (AIHA): the UK experience

et al. 2020

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Seasonal variation in the incidence of cold agglutinin disease in Norway, Denmark, and Italy

et al. 2021

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Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia characterized by monoclonal autoantibodies targeting red blood cell surface structures, showing a binding optimal temperature below 37°C. During cold weather, patients with CAD often suffer from increased hemolysis and may report worsening of symptoms such as acrocyanosis, dark urine, or Raynaud-like symptoms. The primary prophylaxis is to avoid exposure to low temperatures. 1,2 Cold agglutinin disease is predominantly a disease of old age, and is extremely rare before 50 years. [1][2][3][4] Crude incidence rates vary across Europe. 1,3 The crude incidences in Denmark and Norway are comparable, with rates of 18 to 19/100 000 person-years, respectively. 1,3 Differently from these northern countries, the crude incidence rate in Lombardy, Italy, is only 4.8/100 000 person-years, despite a comparable or larger proportion of elderly. 1 A possible explanation could be the climatic differences, particularly considering outdoor temperature. 1,5 Cold weather could trigger symptoms that would lead to clinical examination and a subsequent diagnosis more often than warmer weather. To evaluate this proposed explanation we compared the monthly incidence of CAD in Norway, Denmark, and Lombardy expecting a seasonal pattern. We further compared with the monthly incidence of other acquired hemolytic disorders in Denmark to asses if a seasonal pattern was present in other acquired hemolytic conditions.

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<p>Increasing Incidence and Prevalence of Acquired Hemolytic Anemias in Denmark, 1980–2016</p>

Cited by 32 publications

References 36 publications

Autoimmune hemolytic anemia: current knowledge and perspectives

Autoimmune hemolytic anemia: current knowledge and perspectives

Developing the evidence base for the management of autoimmune haemolytic anaemia (AIHA): the UK experience

Seasonal variation in the incidence of cold agglutinin disease in Norway, Denmark, and Italy

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