Publication Details
Abstract
Autoimmune hemolytic anemia (AIHA) is a heterogeneous group of immune-mediated disorders characterized by the premature destruction of red blood cells due to the production of autoantibodies directed against erythrocyte surface antigens. Although the disease is relatively rare, it remains clinically important due to its potential severity, diagnostic complexity, and frequent association with systemic autoimmune diseases, lymphoproliferative disorders, infections, and drug exposure. The diagnostic process requires a combination of clinical assessment and laboratory investigations, with particular emphasis on identifying hemolysis and confirming immune-mediated mechanisms.The direct antiglobulin test (DAT), also known as the Coombs test, is considered the cornerstone of laboratory diagnosis. However, recent studies have shown that a subset of patients may present with DAT-negative autoimmune hemolysis, which complicates diagnosis and may delay treatment. Therefore, modern diagnostic strategies emphasize an integrated approach that includes hematological parameters, peripheral blood smear evaluation, and advanced immunopharmacological techniques.This literature review summarizes current evidence from 2020 to 2026 regarding the clinical presentation, laboratory features, immunopathogenesis, and diagnostic challenges of AIHA, with a particular focus on improving diagnostic accuracy and recognizing atypical forms of the disease.