Anemia and Hashimoto Thyroiditis

Caroline Cromwell, MD and Marc J. Kahn, MD, MBA

Dr. Cromwell: Icahn School of Medicine, New York, NY
Dr. Kahn: Tulane University School of Medicine, New Orleans, LA

Copyright of the American Society of Hematology, 2013. ISSN: 1931-6860.


  1. Autoimmune hemolytic anemia (AIHA) is characterized by anemia, positive direct antiglobulin test (DAT, or Coombs test), elevated indirect bilirubin, decreased haptoglobin (in severe hemolysis), elevated LDH, and reticulocytosis.
  2. The DAT, or Coombs test, is used to detect antibodies on the surface of the red blood cell.
  3. Not all patients with a positive DAT have hemolytic anemia.
  4. Treatment varies based on the underlying pathophysiology.
  5. First line treatment for warm autoimmune hemolytic anemia is corticosteroids.
  6. Although an etiology is not always found, one should always search for an underlying diagnosis.

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