N. Mariana S. Vasquez/X
Sep 5, 2026, 02:28
N. Mariana S. Vasquez: Warm vs Cold Autoimmune Hemolytic Anemia for USMLE/NBME Questions
N. Mariana S. Vasquez, IMG Physician, shared a post on X:
“Warm vs Cold Autoimmune Hemolytic Anemia
The easiest way to separate them on USMLE/NBME questions:
Warm AIHA
- IgG – reacts at body temperature
- Extravascular hemolysis in the spleen
- Spherocytes
- Positive direct Coombs test for IgG
Classic associations: SLE, CLL, methyldopa
Cold agglutinin disease
- IgM – reacts in cold temperatures – Complement activation – hemolysis – RBC agglutination
- Positive direct Coombs test for C3
Classic associations: Mycoplasma pneumoniae, EBV, lymphoproliferative disorders
USMLE / NBME shortcut
Warm – IgG – Spleen – Spherocytes
Cold – IgM – Complement – Agglutination
Clinical clue: Patient with pneumonia develops acrocyanosis/Raynaud-like symptoms and hemolysis
Think cold agglutinin disease.”
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