scholarly journals Drug-induced autoimmune hemolytic anemia

2020 ◽  
Author(s):  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Drug Induced

scholarly journals First Report of Eltrombopag Induced Severe Autoimmune Hemolytic Anemia in the Management of Waldenström Macroglobulinemia-associated Autoimmune Thrombocytopenia

2021 ◽  
Author(s):  
Yingying Shen ◽  
Hangping Ge ◽  
Baodong Ye ◽  
Zhiyin Zheng ◽  
Keding Shao ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Single Treatment ◽  
Autoimmune Thrombocytopenia ◽  
Drug Induced ◽  
Case Presentation ◽  
Waldenström Macroglobulinemia ◽  
First Report ◽  
Waldenstrom Macroglobulinemia ◽  
Platelet Level

Abstract Background: Autoimmune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA) can be observed in Waldenström Macroglobulinemia (WM). The cause of AIHA should be carefully distinguished during the disease management. Case Presentation: A 63-year-old female WM patient complicated with thrombocytopenia, who was admitted to our department with a complaint of abdominal pain. After first half of bortezomib/dexamethasone/rituximab (BRD) chemotherapy, her platelet level recovered, but subsequently decreased to extremely low level (around 1-2×109/L), and the patient suffered from platelet transfusion refractoriness. During the management of refractory thrombocytopenia, the patient developed severe hemolytic anemia, and further tests confirmed warm AIHA. FcγRIIα polymorphism test showed that the patient had FcγRIIα-131RH, which implied that the AIHA may not be WM-related. Given the effects of ibrutinib in controlling WM, ibrutinib single treatment was started, which quickly corrected the thrombocytopenia within five days, but not hemolysis. With a relatively safe platelet level, eltrombopag was stopped, and the hemolysis alleviated within three days after eltrombopag withdrawal. Conclusion: This is the first report on eltrombopag-induced AIHA, and we should always keep in mind of the drug induced hemolysis even in disorders with autoimmune background.

scholarly journals Autoimmune Hemolytic Anemia Induced by Levofloxacin

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Marwan Sheikh-Taha ◽  
Pascale Frenn
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Rare Condition ◽  
White Female ◽  
Coombs Test ◽  
Drug Induced ◽  
Indirect Bilirubin ◽  
Patient Reported

Drug-induced autoimmune hemolytic anemia is a rare condition. We report the case of a 32-year-old white female who presented to the emergency department with generalized fatigue, fever, and jaundice. The patient reported using levofloxacin few days prior to presentation for urinary tract infection. The patient had evidence of hemolytic anemia with a hemoglobin of 6.7 g/dL which dropped to 5 g/dL on day 2, the direct Coombs test was positive, indirect bilirubin was 5.5 mg/dL, and LDH was 1283 IU/L. Further testing ruled out autoimmune disease, lymphoma, and leukemia as etiologies for the patient’s hemolytic anemia. Levofloxacin was immediately stopped with a gradual hematologic recovery within few days.

scholarly journals How I treat warm autoimmune hemolytic anemia

Blood ◽  
2021 ◽  
Author(s):  
Wilma Barcellini ◽  
Bruno Fattizzo
Keyword(s):  
Bone Marrow ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Bone Marrow Failure ◽  
Clinical Severity ◽  
Therapeutic Interventions ◽  
Drug Induced ◽  
Bone Marrow Failure Syndromes ◽  
Dependent Cell ◽  
Changes Over Time

Warm autoimmune hemolytic anemia (wAIHA) is caused by increased erythrocyte destruction by IgG autoantibodies, with or without complement activation. Antibody-dependent cell-mediated cytotoxicity by macrophages/activated lymphocytes occurs in the lymphoid organs and spleen (extravascular hemolysis). The ability of the bone marrow to compensate determines clinical severity. The different pathogenic mechanisms, their complex interplay, and changes over time may explain wAIHA's great clinical heterogeneity and unpredictable course. The disease may be primary, drug-induced, or associated with lymphoproliferative neoplasms, autoimmune and infectious diseases, immunodeficiencies, solid tumors, or transplants. Therapeutic interventions include steroids, splenectomy, immunosuppressants, and rituximab; the latter is increasingly used in steroid refractory cases based on evidence from the literature and a few prospective trials. We present five patient case studies highlighting important issues: 1) the diagnosis and proper use of steroid therapy; 2) the concerns about the choice between rituximab and splenectomy in second-line treatment; 3) the need of periodical re-evaluation of the disease to assess the possible evolution of relapsed/refractory cases in myelodysplastic and bone marrow failure syndromes; and 4) the difficulties in managing cases of severe/acute disease which are at high risk of relapse. Incorporating novel targeted therapies into clinical practice will be an exciting challenge in the future.

scholarly journals Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders

2021 ◽  
Vol 10 (3) ◽  
pp. 423
Author(s):  
Cristiana Bianco ◽  
Elena Coluccio ◽  
Daniele Prati ◽  
Luca Valenti
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Primary Biliary Cholangitis ◽  
Drug Induced ◽  
Adequate Treatment ◽  
High Clinical Suspicion ◽  
Bowel Diseases ◽  
Choice Of Treatment ◽  
Bowel Disorders ◽  
Biochemical Indices

Anemia is a common feature of liver and bowel diseases. Although the main causes of anemia in these conditions are represented by gastrointestinal bleeding and iron deficiency, autoimmune hemolytic anemia should be considered in the differential diagnosis. Due to the epidemiological association, autoimmune hemolytic anemia should particularly be suspected in patients affected by inflammatory and autoimmune diseases, such as autoimmune or acute viral hepatitis, primary biliary cholangitis, and inflammatory bowel disease. In the presence of biochemical indices of hemolysis, the direct antiglobulin test can detect the presence of warm or cold reacting antibodies, allowing for a prompt treatment. Drug-induced, immune-mediated hemolytic anemia should be ruled out. On the other hand, the choice of treatment should consider possible adverse events related to the underlying conditions. Given the adverse impact of anemia on clinical outcomes, maintaining a high clinical suspicion to reach a prompt diagnosis is the key to establishing an adequate treatment.

scholarly journals Inflammatory Breast Cancer and Warm Antibody Autoimmune Hemolytic Anemia: A Rare Paraneoplastic Syndrome

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774090 ◽  
Author(s):  
Nene Ugoeke ◽  
Chidinma Onweni ◽  
Jennifer Treece ◽  
Vandana Pai ◽  
Sowminya Arikapudi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hemolytic Anemia ◽  
Inflammatory Breast Cancer ◽  
Paraneoplastic Syndrome ◽  
Autoimmune Hemolytic Anemia ◽  
Disease Process ◽  
Solid Cancer ◽  
Drug Induced ◽  
Solid Malignancy ◽  
Solid Malignancies

Autoimmune hemolytic anemia (AIHA) is a disease process that involves the destruction of red blood cells mediated by the humoral immune system. It can be characterized as a cold agglutinin syndrome, paroxysmal cold hemoglobinuria, and warm, mixed type, and drug-induced AIHA. Although a well-established relationship exists between the presence of AIHA and lymphoproliferative malignancy, AIHA rarely presents in association with solid malignancies. An analysis of the limited number of published cases of AIHA in association with solid malignancies performed showed that AIHA may present before the diagnosis of a solid malignancy, concurrently with the presence of a solid malignancy, or even on resolution of a solid malignancy. Few cases of solid cancers associated with AIHA have been reported. AIHA rarely presents as a paraneoplastic syndrome indicating existence of a solid cancer. We report a case of inflammatory breast cancer with AIHA.

scholarly journals Rare presentation of mixed autoimmune hemolytic anemia in children: Report of 2 cases

2017 ◽  
Vol 9 (04) ◽  
pp. 332-336 ◽  
Author(s):  
Preeti Rai ◽  
Geetika Sharma ◽  
Deeksha Singh ◽  
Jyoti Garg
Keyword(s):  
Blood Group ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Drug Induced ◽  
Rare Presentation ◽  
Indirect Antiglobulin Test ◽  
Immune Hemolytic Anemia ◽  
Thermal Amplitude ◽  
Antiglobulin Test ◽  
Cross Match

AbstractImmune hemolytic anemia is characterized by clinical and laboratory features of hemolytic anemia with direct antiglobulin test (DAT) positivity. It could be autoimmune hemolytic anemia (AIHA), alloimmune, or drug-induced hemolysis based on the antigenic stimulus. Furthermore, based on thermal amplitude of autoantibody, AIHA is classified as warm (65%), cold (30%), and mixed (5%) type. Mixed AIHA is extremely rare in children and must be differentiated from warm AIHA with clinically insignificant cold agglutinins and cold hemagglutinin disease as their treatment is different. It may present as blood group discrepancy or cross-match incompatibility leading to delay in arranging suitable blood unit for transfusion. Therefore, a thorough immunohematology workup including monospecific DAT, indirect antiglobulin test at 4°C and 37°C, determination of thermal amplitude and titer is essential. We hereby present two pediatric cases of mixed AIHA presenting as ABO forward and reverse blood group discrepancy and cross-match incompatibility.

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