Certified Pediatric Hematology Oncology Nurse (CPHON) Practice Exam 2025 - Free CPHON Practice Questions and Study Guide

In the context of Cold Antibody Autoimmune Hemolytic Anemia (AIHA), hemolysis primarily occurs in the liver. This is due to the fact that the antibodies involved in cold AIHA, typically IgM autoantibodies, bind to red blood cells when the body is exposed to cold temperatures. After binding, these red blood cells can be sequestered and destroyed in the liver's reticuloendothelial system, particularly by Kupffer cells, which are specialized macrophages found in the liver.

The phenomenon of hemolysis in the liver reflects the organ's role in filtering and removing altered or damaged blood cells from circulation. As a result, the liver becomes a key site for the clearance of red blood cells coated with these cold antibodies, leading to the hemolytic process characteristic of this condition.

While other organs like the spleen and bones can play roles in the clearance and processing of blood cells, in the case of Cold AIHA, the liver's involvement is particularly significant due to the mechanisms of antibody-mediated destruction that occur therein.