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Introduction: Although rituximab is approved for several autoimmune diseases, no formal dose finding studies have been conducted. The amount of CD20+ cells differs significantly between autoimmune diseases and B-cell malignancies. Hence, dose requirements of anti-CD20 therapies may differ accordingly.

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Introduction: Toxoplasma gondii (T. gondii) infects all warm-blooded animals, including humans. Currently, no effective treatments exist to prevent the generation of chronic tissue cysts in infected hosts.

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Autoimmune Hemolytic Anemias: Challenges in Diagnosis and Therapy.

Transfus Med Hemother

October 2024

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Article Synopsis
  • Autoimmune hemolytic anemia (AIHA) is a rare condition characterized by the destruction of red blood cells due to autoantibodies, with two main types: warm AIHA (wAIHA) and cold agglutinin disease (CAD).
  • Diagnosis relies on the direct antiglobulin test (DAT), which shows different results depending on the type of AIHA, affecting treatment options, as steroids work for wAIHA, but less so for CAD.
  • The article discusses the varying clinical presentations and treatment challenges for AIHA, highlighting new therapies currently in trials for those who do not respond to standard treatments.
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Autoimmune hemolytic anemia (AIHA) is characterized by the accelerated destruction of erythrocytes due to the presence of antibodies and/or complement that bind to antigens on erythrocytes. It can be subdivided into warm, cold or mixed AIHA based on the type of autoantibody and the optimal temperature of antigen-antibody reaction. Glucocorticoid with or without rituximab is the first-line treatment of warm AIHA (wAIHA), and splenectomy was once the preferred second-line treatment for relapsed or refractory wAIHA.

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Although rituximab is not specifically approved for the treatment of warm autoimmune hemolytic anemia (WAIHA), the First International Consensus Group recommends considering its use as part of the initial therapy for patients with severe disease and as a second-line therapy for primary WAIHA. Some patients do not respond to rituximab, and relapses are common. These relapses are associated with elevated B-cell-activating factor (BAFF) levels and the presence of quiescent long-lived plasma cells (LLPCs) in the spleen.

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