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Review

Thrombotic Complications in Patients with Immune-Mediated Hemolysis

by
Marco Capecchi
1,2,*,
Alessandro Ciavarella
1,2,
Andrea Artoni
2,
Maria Abbattista
2 and
Ida Martinelli
2
1
Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
2
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(8), 1764; https://doi.org/10.3390/jcm10081764
Submission received: 3 March 2021 / Revised: 10 April 2021 / Accepted: 15 April 2021 / Published: 18 April 2021
(This article belongs to the Section Hematology)
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Abstract

Autoimmune hemolytic anemias are rare and heterogeneous disorders characterized by hemolysis, which is a well-recognized risk factor for thrombosis. The most common immune-mediated anemias are represented by autoimmune hemolytic anemia and paroxysmal nocturnal hemoglobinuria, both associated with a high rate of thrombosis. Multiple pathophysiological mechanisms for thrombosis have been proposed, involving hemolysis itself and additional effects of the immune system. Despite the increasing awareness of the thrombotic risk in these conditions, evidence-based guidance on prevention and management of thrombotic events is lacking. We herein report available evidence on epidemiological data on thrombosis and thrombophilia in immune-mediated hemolysis, together with possible underlying pathophysiological mechanisms. In addition, we summarize current recommendations for treatment of thrombosis in immune-mediated hemolysis. In particular, we address the issue of thrombotic complications treatment and prophylaxis by proposing a therapeutic algorithm, focusing on specific situations such as splenectomy and pregnancy.
Keywords: hemolytic anemia; paroxysmal nocturnal hemoglobinuria; thrombosis; anticoagulants; thrombophilia hemolytic anemia; paroxysmal nocturnal hemoglobinuria; thrombosis; anticoagulants; thrombophilia

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MDPI and ACS Style

Capecchi, M.; Ciavarella, A.; Artoni, A.; Abbattista, M.; Martinelli, I. Thrombotic Complications in Patients with Immune-Mediated Hemolysis. J. Clin. Med. 2021, 10, 1764. https://doi.org/10.3390/jcm10081764

AMA Style

Capecchi M, Ciavarella A, Artoni A, Abbattista M, Martinelli I. Thrombotic Complications in Patients with Immune-Mediated Hemolysis. Journal of Clinical Medicine. 2021; 10(8):1764. https://doi.org/10.3390/jcm10081764

Chicago/Turabian Style

Capecchi, Marco, Alessandro Ciavarella, Andrea Artoni, Maria Abbattista, and Ida Martinelli. 2021. "Thrombotic Complications in Patients with Immune-Mediated Hemolysis" Journal of Clinical Medicine 10, no. 8: 1764. https://doi.org/10.3390/jcm10081764

APA Style

Capecchi, M., Ciavarella, A., Artoni, A., Abbattista, M., & Martinelli, I. (2021). Thrombotic Complications in Patients with Immune-Mediated Hemolysis. Journal of Clinical Medicine, 10(8), 1764. https://doi.org/10.3390/jcm10081764

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