MyMedR

Haemolysis due to glucose-6-phosphate dehydrogenase deficiency in Malaya

Lie-Injo Luan Eng, Pillay RP, Virik HK

Trans R Soc Trop Med Hyg, 1966;60(2):262-6.

PMID: 5922616 DOI: 10.1016/0035-9203(66)90039-3

Matched MeSH terms: Anemia, Hemolytic, Congenital/epidemiology*

Microangiopathic haemolytic anaemia and thrombocytopenia due to combined vitamin B12 and folate deficiency masquerading as thrombotic thrombocytopenic purpura

Lee KT, Teoh CS, Chew TK, Goh AS

J R Coll Physicians Edinb, 2020 Jun;50(2):144-147.

PMID: 32568285 DOI: 10.4997/JRCPE.2020.213

Vitamin B12 deficiency and folate deficiency are common causes of macrocytic anaemia and both are important for many cellular processes. These deficiencies could be due to inadequate dietary intake, impaired absorption or drug ingestion. We present a case of a 47-year-old male with a history of diffuse large B-cell lymphoma (DLBCL) who was admitted for fatigue, persistent frontal headache and left upper-quadrant abdominal pain. Further investigation showed that he had pancytopenia with microangiopathic haemolytic anaemia (MAHA) and intracranial bleeding (ICB). Serum vitamin B12 and folate were later found to be low and a diagnosis of combined vitamin B12 and folate deficiency mimicking thrombotic thrombocytopenic purpura (TTP) was made. The patient responded well to vitamin B12 and folate replacement.

Matched MeSH terms: Anemia, Hemolytic

Prolonged remission after splenectomy for refractory Evans syndrome--a case report and literature review

Hamidah A, Thambidorai CR, Jamal R

Southeast Asian J. Trop. Med. Public Health, 2005 May;36(3):762-4.

PMID: 16124452

We describe a patient with Evans syndrome (autoimmune hemolytic anemia and autoimmune thrombocytopenia) who was refractory to steroids and intravenous immunoglobulin. She responded to splenectomy and has remained in clinical remission for 3 years. In the majority of cases, splenectomy rarely induces a durable remission but it may be beneficial in a small group of patients, hence should be considered as alternative therapy in the management of these patients.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune/diagnosis; Anemia, Hemolytic, Autoimmune/therapy*

Fulltext Causes of low HbA1c in Malaysian university hospital

Sthaneshwar P, Vethakkan SR, Wong CW

Med J Malaysia, 2014 Aug;69(4):175-7.

PMID: 25500845 MyJurnal

INTRODUCTION: Glycohemoglobin (HbA1c) most accurately reflects the previous two to three months of glycaemic control. HbA1c should be measured regularly in all patients with diabetes, and values should be maintained below 7% to prevent the risk of chronic complications. Apart from the genetic variants of haemoglobins many other conditions also known to affect HbA1c measurements. In this study we evaluated the conditions that cause low HbA1c results.

METHODS AND MATERIALS: The data was collected retrospectively HbA1c was measured in our laboratory by Biorad Variant II turbo 2.0. The method is based on chromatographic separation of HbA1c on a cation exchange cartridge. This method has been certified by National Glycohemoglobin Standardization Programme (NGSP). 58437 requests were received in a period of one year (January to December 2011). Medical records were reviewed to identify the conditions that might be associated with these low values.

RESULTS: Among 58437 samples analysed, 53 patients had HbA1c levels < 4.0%. Fourteen patients had haemoglobinopathy. In 34 patients without Hb variants had conditions such as chronic liver disease, chronic kidney disease, haemolytic anaemia, pregnancy, and anaemia of chronic disease. Five non-pregnant individuals who were screened for diabetes mellitus had HbA1c levels < 4%.

CONCLUSION: Our study underscores the importance of that both laboratories and the physicians should be aware of the factors that can influence the HbA1c results. The haematological status should be taken into consideration for proper interpretation of HbA1c results.

Matched MeSH terms: Anemia, Hemolytic

Fulltext A rare case of autoimmune hepatitis overlapping with autoimmune haemolytic anaemia and immune thrombocytopenic purpura in a male patient

Palaniappan S, Ramanaidu S

Med J Malaysia, 2012 Jun;67(3):326-8.

PMID: 23082427 MyJurnal

Matched MeSH terms: Anemia, Hemolytic, Autoimmune/complications*; Anemia, Hemolytic, Autoimmune/diagnosis; Anemia, Hemolytic, Autoimmune/drug therapy

Fulltext Cold agglutinins in low-grade B-cell lymphoma

Fadilah SA, Hamidah AB, Cheong SK

Med J Malaysia, 1999 Sep;54(3):383-5.

PMID: 11045070

The presence of serum cold agglutinin can be the initial presentation of lymphoproliferative diseases. Conditions with persistent cold agglutinins are a spectrum of diseases that vary from benign lymphoproliferation of the "autoimmune-like chronic cold agglutinin disease" to malignant lymphoma. We report a case of a 72-year-old woman who presented with severe anaemia, hepatosplenomegaly and episodes of peripheral haemagglutination precipitated by cold exposure. The haemoglobin was 5.6 g/dL with a cold agglutinin titer of 1:256 at 4 degrees C and 1:8 at room temperature (30 degrees C). The cold agglutinin showed anti-I specificity and kappa light chain restriction. Peripheral blood showed atypical lymphoid cells with a B-cell immunophenotype. Immunoglobulin gene rearrangement study by polymerase chain reaction (PCR) showed an amplified band at 100 bp, consistent with a clonal proliferation of B-lymphocytes. We believe that our patient had cold antibody haemolytic anaemia as the initial presentation of a low-grade non-Hodgkin's lymphoma. The association of cold antibody haemolytic anaemia with low-grade B-cell lymphoma is unusual.

Matched MeSH terms: Anemia, Hemolytic/blood; Anemia, Hemolytic/etiology

Fulltext Positive direct antiglobulin test with Unasyn--a case report

Leong CF, Cheong SK, Fadilah SA

Med J Malaysia, 1999 Dec;54(4):517-9.

PMID: 11072473

A 56-year-old Chinese lady with valvular heart disease and atrial fibrillation was referred to us from a private hospital for further management of autoimmune haemolytic anaemia. Physical examination and laboratory investigations did not support the diagnosis of haemolytic anaemia. However, direct antiglobulin test (DAT) was strongly positive with anti-IgG and negative with anti-C3d. There was also mild anaemia and reticulocytosis, which was attributable to persistent haematuria. The DAT became positive after commencing Unasyn and cessation was associated with decreasing reactivity of the positive DAT. We believe that the positive DAT in this patient was most likely due to the Unasyn therapy.

Matched MeSH terms: Anemia, Hemolytic/diagnosis

Fulltext Acne fulminans with dapsone induced haemolysis: a case report

Ismail R

Med J Malaysia, 1987 Jun;42(2):124-6.

PMID: 2971861

Acne is one of the most common disorders affecting mankind. Although acne does not cause death, it however produces a lot of discomfort, disfigurement and psychological trauma, particularly in teenagers. Acne vulgaris is a chronic condition involving the pilosebaceous unit of the skin. It is characterised by the presence of comedones, inflammatory papules, pustules or cysts, and eventually by scarring. The end result of acne varies from hyperpigmentation, slight pitting, to extremely disfiguring scars that may develop into keloids. Acne fulminans is a rare disorder and is characterised by sudden explosive appearance of highly inflammatory, tender, crusted, ulcerated lesions involving the back, chest and face. It is one of the most scarring acute dermatologic disorders of young people. A case of acne fulminans in a young female who developed haemolysis due to dapsone is reported here.

Matched MeSH terms: Anemia, Hemolytic/chemically induced*

Fulltext Homozygous haemoglobin E in association with hereditary ovalocytosis

George E, Kudva MV

Med J Malaysia, 1989 Sep;44(3):255-8.

PMID: 2626141

Hereditary stomatocytic ovalocytosis and haemoglobin E are two genes present in 3-5% of Malays. This is a report of a 22 year old Malay college student with homozygous haemoglobin E and hereditary stomatocytic ovalocytosis where the clinical effects seen were the result of the summation of these genes: he was asymptomatic, presenting with moderate jaundice, moderate hepatosplenomegaly, and a mild haemolytic anaemia.

Matched MeSH terms: Anemia, Hemolytic/genetics

Hyperthyroidism and autoimmune hemolytic anemia--a case report

Chee YC, Gill DS, Poh SC

Med J Malaysia, 1978 Dec;33(2):154-5.

PMID: 755168

Matched MeSH terms: Anemia, Hemolytic, Autoimmune/complications*

A case report of severe mycoplasma pneumonia with autoimmune haemolytic anaemia

Roshan S, Tan SW

Med J Malaysia, 2020 09;75(5):600-602.

PMID: 32918437

Mycoplasma pneumonia is a common cause of respiratory disease and more so in school going children. The spectrum of the manifestations range from haematological, dermatological, neurological, musculoskeletal, renal, cardiac and also gastrointestinal. The treatment approach has varied over time. In this report we would like to share our experience in a case of M.pneumonia with autoimmune haemolytic anaemia (AIHA).

Matched MeSH terms: Anemia, Hemolytic, Autoimmune*

SERUM IRON AND IRON BINDING CAPACITY IN MALAYANS

ENG LL, DEWITT G

Med J Malaysia, 1964 Jun;18:269-75.

PMID: 14199445

Matched MeSH terms: Anemia, Hemolytic*

Brucellosis-induced autoimmune haemolytic anaemia (AIHA)

Mak WW, Adrian MM, Ahlam K

Med J Malaysia, 2019 Oct;74(5):443-344.

PMID: 31649226

Brucellosis is a rare zoonotic infection caused by small, fastidious Gram-negative coccobacilli of the genus Brucella that may be associated with haemolytic complications including thrombotic microangiopathy and haemolytic anaemia. We describe a patient with culture confirmed brucellosis who presented with malaise, high grade fever, hepatosplenomegaly and Coombs-positive autoimmune haemolytic anaemia. The patient was successfully treated with combination of doxycycline and rifampicin with no further episodes of relapses or haemolysis. Although rare, the possibility of brucellosis should always be kept in mind in patients with risk factors who present with haemolysis and endemic area.

Matched MeSH terms: Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune

Hereditary elliptocytosis with acute lymphoblastic leukaemia

TI TS

Med J Malaya, 1962 Mar;16:214-8.

PMID: 13921142

Matched MeSH terms: Anemia, Hemolytic/genetics*

Hereditary haemolytic anaemias in West Malaysia

Lopez CG, Lie-Injo Luan Eng

Med J Malaya, 1969 Dec;24(2):101-6.

PMID: 4244132

Matched MeSH terms: Anemia, Hemolytic/etiology*; Anemia, Hemolytic/genetics*

Autoimmune haemolytic anaemia

CHAN KE, THURAISINGHAM V

Med J Malaya, 1963 Mar;17:163-9.

PMID: 14019984

Matched MeSH terms: Anemia, Hemolytic*; Anemia, Hemolytic, Autoimmune*

Haemolytic jaundice in a drugsensitive patient in Singapore

VELLA F, Phoon WO

Med J Malaya, 1959 Jun;13:309-12.

PMID: 13841617

Matched MeSH terms: Anemia, Hemolytic/etiology*

Susceptibility to drug-induced haemolysis in Singapore

VELLA F

Med J Malaya, 1959 Jun;13:298-308.

PMID: 13841622

Matched MeSH terms: Anemia, Hemolytic/etiology*

Chronic haemolytic anaemia; a report of three cases of Cooley's anaemia and five cases of acholuric jaundice seen in Malaya with a discussion on the differential diagnosis

FIELD CE, TAN EE

Med J Malaya, 1955 Sep;10(1):60-82.

PMID: 13287496

Matched MeSH terms: Anemia, Hemolytic, Congenital/diagnosis*

Markedly raised haemolysis index with upper limit of normal serum potassium levels

Kathiravelu Z, Thambiah SC, Mat Salleh MJ, Samsudin IN

Malays J Pathol, 2021 Apr;43(1):101-107.

PMID: 33903313

INTRODUCTION: Haemolytic specimens are a frequent occurrence in clinical laboratories, and they interfere with the analysis of many tests.

CASE REPORT: We describe here an unusual case of leptospirosis complicated by haemolytic anaemia in a 70-year-old man with established kidney failure. He presented with an abrupt onset of shortness of breath, flushing and erythematous rash after completing haemodialysis. The patient's biochemistry test samples were however rejected twice as they were grossly haemolysed. The integrated auto-verification alert system implemented in the hospital's laboratory information system alerted the staff of the possibility of in vivo haemolysis.

DISCUSSION: The auto-verification alert system effectively distinguishes between in vitro and in vivo haemolysis and as such can be utilised as a diagnostic aid in patients with suspected intravascular haemolysis.

Matched MeSH terms: Anemia, Hemolytic

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