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There are varied mechanisms by which self-tolerance is lost, but, as with primary IMHA, it is probably multifactorial.15 For example, in infectious diseases such as mycoplasmosis in cats and babesiosis in cats and dogs, there is hemolysis caused by both the organism itself and a secondary immunologic response

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The transcription factor involved in response to amino acid starvation is activating transcription factor 4 (ATF4), which binds to the CSE promoter in addition to promoters of other amino acid biosynthetic and transport genes (Harding et al ., 2003)

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