MyMedR

Fulltext Immune haemolysis after renal transplantation secondary to ABO minor-mismatch between donor and recipient

Jayaranee S, Ramesh P, Nadesan V

Singapore Med J, 2002 Aug;43(8):421-2.

Immune haemolysis following renal transplantation has been reported and known causes include infection, medication and metabolic disturbances (1,2). Autoimmune haemolysis after renal transplantation secondary to ABO minor mismatch is an uncommon but important cause that should be considered in the differential diagnosis of post-transplantation haemolysis. A case of haemolytic anaemia caused by graft versus host antibody formation is presented. We suggest that direct Coomb's test should be done as a routine in all cases of ABO mismatch renal transplantation and red cells compatible with both donor and recipient or group "O" packed cells should be transfused if transfusion is indicated.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune/etiology*; Anemia, Hemolytic, Autoimmune/immunology

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

The treatment of malaria in glucose-6-phosphate dehydrogenase deficient patients in Sabah

Khoo KK

Ann Trop Med Parasitol, 1981 Dec;75(6):591-5.

PMID: 7325735 DOI: 10.1080/00034983.1981.11687489

One hundred and nine (9·8%) out of 1103 malaria patients examined in Sabah were deficient in glucose-6-phosphate dehydrogenase (G6PD). Sixty-nine of these G6PD-deficient patients were randomly allocated to one of three treatment regimes with (a) chloroquine, (b) chloroquine and primaquine or (c) sulfadoxine-pyrimethamine (Fansidar). No haemolysis was observed in group (a); except for a single mild case, no haemolysis was seen in group (c). However, in the primaquine group (23 patients), haemolysis occurred in seven of the 16 patients who had complete G6PD deficiency. Of these seven, five required blood transfusion and the other two developed acute renal failure, one requiring peritoneal dialysis. In the Fansidar group (c), four of the 22 patients took more than 15 days to clear the parasitaemia. Chloroquine resistance to falciparum infection was common in the patients given this anti-malarial.
Study site: Queen Elizabeth Hospital, Kola Kinabalu, Sabah, Malaysia

Matched MeSH terms: Anemia, Hemolytic/chemically induced

IDIOPATHIC AUTO-IMMUNE HAEMOLYTIC ANAEMIA IN MALAYA

LIE-INJOLUAN EN, PILLAY RP

Acta Haematol., 1964 May;31:282-8.

PMID: 14172696

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

Blackwater fever or Lederer's anaemia?

Landor J

Journal of the Malaya Branch of the British Medical Association, 1937;1:184-87.

Matched MeSH terms: Anemia, Hemolytic

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

Fulltext What G6PD-deficient individuals should really avoid

Lee SW, Chaiyakunapruk N, Lai NM

Br J Clin Pharmacol, 2017 01;83(1):211-212.

PMID: 27650490 DOI: 10.1111/bcp.13091

Matched MeSH terms: Anemia, Hemolytic/etiology; Anemia, Hemolytic/prevention & control*

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

Inheritance of haemoglobin H disease. A new aspect

Lie-Injo LE, Lopez CG, Lopes M

Acta Haematol., 1971;46(2):106-20.

PMID: 4331171 DOI: 10.1159/000208565

A study of 23 patients with Hb H disease and their 82 relatives in 17 families showed that 2 types of this condition exist. One is associated with the presence of a small slow-moving component, which we tentatively called the X component and which was invariably present in one parent. Some siblings also had it. The other type was not associated with this component. Two patients without X component had a newborn with Bart’s haemoglobin without X component. None of the parents of 20 newborns with Hb Bart’s without the X component had the X component. It was present in only one parent of each of 2 newborns with Hb Bart’s and the X component. They are thought to represent Hb H disease in the newborn period. We suggest that at least 3 abnormal genes may lead to Hb H disease, which results when 2 of the 3 combine. Severity of clinical and haematological symptoms depends upon which abnormal gene is present and which 2 are involved in any particular combination.
Key Words: a-Thalassaemia; Haemoglobin Bart’s; Haemoglobin H disease; Haemoglobinopathies

Matched MeSH terms: Anemia, Hemolytic/complications

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*

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*

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

Evans syndrome: a report on 12 patients

Ng SC

Clin Lab Haematol, 1992;14(3):189-93.

PMID: 1451398

From 1981 to 1989, 12 patients of the University Hospital, Kuala Lumpur, were diagnosed to have Evans syndrome based on direct antiglobulin test (DAT) positive haemolytic anaemia and immune thrombocytopenia occurring either simultaneously (7 patients) or consecutively (5 patients). Their mean age at presentation was 24.8 years with a marked female preponderance. All 12 patients were given high dose steroid after diagnosis. Subsequently, other modalities including intravenous immunoglobulin (1 patient) and high dose methylprednisolone (1 patient) were given. Three patients died of intracranial haemorrhage during the first admission while 1 patient died of pulmonary embolism six months after diagnosis. Three patients had splenectomy because of thrombocytopenia. Six patients tested positive for antinuclear factor and antibodies to double stranded DNA and four of them died. Positive serology appeared to be associated with a poorer prognosis. Follow up observations indicate that patients who survive the acute attacks fare reasonably well.

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

Autoimmune haemolytic anaemia in pregnancy: a case report

Ng SC, Wong KK, Raman S, Bosco J

Eur J Obstet Gynecol Reprod Biol, 1990 Oct;37(1):83-5.

PMID: 2376282

A young primigravida had idiopathic warm antibody (IgG) autoimmune haemolytic anaemia (AIHA) occurring in the third trimester of pregnancy. Her haemolytic process was responsive to steroid therapy and no transfusion was needed. She delivered a healthy baby with no evidence to haemolysis, though his red cells were coated with IgG which was probably of maternal origin.

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

Post-transfusion hypertension and seizure in congenital hemolytic anemia: a case report and literature review

Ngim CF, Ng CS, Lai NM

J Trop Pediatr, 2014 Jun;60(3):253-6.

PMID: 24473404 DOI: 10.1093/tropej/fmu003

A rare syndrome of hypertension, seizures and intracranial bleed has been reported among patients with congenital hemolytic anemia who underwent multiple blood transfusions. We report this syndrome in a 12-year-old Malay girl with hemoglobin E-beta-thalassemia, who underwent intensive transfusion and subsequently had headache, visual loss, severe hypertension and seizures. A comprehensive literature review revealed 30 patients with this syndrome, of whom 15 had intracranial bleed and 12 among these 15 died. A less-intensive transfusion regimen among patients with chronic hemolytic anemia and prompt detection and management of hypertension may prevent this potentially fatal syndrome.

Matched MeSH terms: Anemia, Hemolytic, Congenital

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 Does glucose-6-phosphate dehydrogenase deficiency modify the course of leprosy or its treatment

Pettit JHS, Chin J

Lepr Rev, 1964 Jul;35(4):149-56.

PMID: 14177689

In a survey of over 1,000 patients with leprosy, 47 cases ( 4.4 per cent) were found to have glucose-6-phosphate dehydrogenase deficiency. A controlled clinical study suggests that such a deficiency does not modify the overall response to therapy but may predispose to a greater tendency to leprosy reactions. All patients were receiving 600 to 800 mgm. of sulphone per week and none had a frank haemolytic anaemia.

Matched MeSH terms: Anemia, Hemolytic*

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*

Fulltext Hemolytic anemia and distal renal tubular acidosis in two Indian patients homozygous for SLC4A1/AE1 mutation A858D

Shmukler BE, Kedar PS, Warang P, Desai M, Madkaikar M, Ghosh K, et al.

Am J Hematol, 2010 Oct;85(10):824-8.

PMID: 20799361 DOI: 10.1002/ajh.21836

Familial distal renal tubular acidosis (dRTA) can be caused by mutations in the Cl2/HCO32 exchanger of the renal Type A intercalated cell, kidney AE1/SLC4A1. dRTA-associated AE1 mutations have been reported in families from North America, Europe, Thailand, Malaysia, Papua-New Guinea, Taiwan, and the Philippines, but not India. The dRTA mutation AE1 A858D has been detected only in the context of compound heterozygosity. We report here two unrelated Indian patients with combined hemolytic anemia and dRTA who share homozygous A858D mutations of the AE1/SLC4A1 gene. The mutation creates a novel restriction site that is validated for diagnostic screening.

Matched MeSH terms: Anemia, Hemolytic, Congenital/complications; Anemia, Hemolytic, Congenital/genetics*

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

Displaying publications 21 - 40 of 46 in total