[Dr.Vad]

Steroids are the first-choice treatment in all cases of warm-type AIHA50–54. Initial treatment involves the use of oral prednisone at a dose of 1–2 mg/kg/day (8.6-B); in the case of poor compliance to oral administration, intravenous methylprednisolone can be used (0.8–1.6 mg/kg/day) (8.6-B); in severe cases, a higher initial dose may be indicated, i.e. intravenous methylprednisolone 1–2 mg/kg every 6–8 hours for 1–3 days (7.9-C). Routine use of high-dose steroids is not recommended (7.1-D).

Intravenous immunoglobulins have been used in AIHA in addition to steroids1,55–61. In a review of 73 cases of AIHA, Flores et al. concluded that treatment with intravenous immunoglobulins (0.4–0.5 g/kg for 5 days) was effective in 39.7% of patients, with a higher efficacy (54.5%) in children55. Intravenous immunoglobulins may, therefore, be indicated as adjunctive therapy to steroids, in more severe cases (7.8-B).

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