MyMedR

BACKGROUND: Non-traumatic, spontaneous subarachnoid hemorrhage occurs in approximately 85% of cases where there is a ruptured saccular aneurysm. An additional 10% of cases arise from non-aneurysmal peri-mesencephalic hemorrhages.

CASE PRESENTATION: We report a rare case of a young female, with underlying Evans syndrome, who was initially thought to have non-hemorrhagic stroke, eventually diagnosed having isolated non-traumatic, non-aneurysmal convexal subarachnoid haemorrhage.

CONCLUSIONS: Spontaneous non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage is a rare entity - of which there are multiple possible etiologies.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune*

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

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*

G6PD deficiency with hemolytic anemia due to a rare gene deletion--a report of the first case in Malaysia

Ainoon O, Boo NY, Yu YH, Cheong SK, Hamidah HN

Hematology, 2006 Apr;11(2):113-8.

PMID: 16753852 DOI: 10.1080/10245330500155184

A 2-year-old Chinese boy was referred to Hospital UKM for investigation of recurrent episodes of dark-coloured urine and pallor since birth. He was born prematurely at 34 weeks gestation and developed severe early-onset neonatal jaundice requiring exchange blood transfusion. Screening at birth showed Glucose-6-phosphate dehydrogenase (G6PD) deficiency. On admission, physical examination revealed pallor, jaundice and mild hepatomegaly. Results of laboratory investigations showed a hemoglobin level of 11.0 g/dl with a hemolytic blood picture, reticulocytosis of 20% and red cell G6PD activity reported as undetectable. The patient's DNA was analysed for G6PD mutations by PCR-based techniques and DNA sequencing and results showed a 24 bp deletion of nucleotide 953-976 in the exon 9 of the G6PD gene. DNA analysis was also performed on blood samples of the patient's mother and female sibling confirming their heterozygous status, although both showed normal red cell G6PD activity levels. The patient was discharged well and his parents were appropriately advised on the condition and the importance of taking folic acid regularly. This is a first case report in Malaysia of G6PD deficiency causing chronic-hemolytic anemia. The rare 24 bp deletion causes the G6PD Nara variant, previously reported only in two other unrelated males, a Japanese and a Portuguese both with chronic hemolytic anemia.

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

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*

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*

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

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 Platelet Alloantibody in Multiply Transfused Thrombocytopenic Patients

Wan Haslindawani Wan Mahmood, Rapiaah Mustaffa

International Medical Journal Malaysia, 2007;6(2):1-10.

MyJurnal

Introduction: Multiply transfused patients are frequently subjected to platelet alloimmunization. These platelet alloantibodies produced can result in refractoriness to platelet transfusion. Material and Methods: Ninety five thrombocytopenic (platelet count

Matched MeSH terms: Anemia, Hemolytic

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 Unstable haemoglobin Köln disease in members of a Malay family

Eng LL, Lopez CG, Eapen JS, Eravelly J, Wiltshire BG, Lehmann H

J Med Genet, 1972 Sep;9(3):340-3.

PMID: 5079107 DOI: 10.1136/jmg.9.3.340

Matched MeSH terms: Anemia, Hemolytic, Congenital Nonspherocytic/blood*; Anemia, Hemolytic, Congenital Nonspherocytic/enzymology; Anemia, Hemolytic, Congenital Nonspherocytic/genetics; Anemia, Hemolytic, Congenital Nonspherocytic/urine

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*

Retinal phlebitis associated with autoimmune hemolytic anemia

Chew FL, Tajunisah I

Ocul Immunol Inflamm, 2009 Nov-Dec;17(6):394-5.

PMID: 20001258 DOI: 10.3109/09273940903260204

To describe a case of retinal phlebitis associated with autoimmune hemolytic anemia.

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

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.

PMID: 12507029

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

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

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

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