MyMedR

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*

Autoimmune haemolytic anaemia

CHAN KE, THURAISINGHAM V

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

PMID: 14019984

Matched MeSH terms: Anemia, Hemolytic, Autoimmune*

Fulltext Isolated non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage in a patient with Evans syndrome

Abdul Rashid AM, Md Noh MSF

BMC Neurol, 2017 Aug 25;17(1):165.

PMID: 28841841 DOI: 10.1186/s12883-017-0944-9

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

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

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

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*

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*

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*

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, Autoimmune*

Fulltext Nocardia kroppenstedtii: a rare pathogen isolated from the spinal vertebral abscess of a patient on long-term immunosuppressive therapy

Tay ST, Wong PL, Chiu CK, Tang SN, Lee JL, Hamdan NW, et al.

Eur Rev Med Pharmacol Sci, 2021 01;25(2):605-608.

PMID: 33577013 DOI: 10.26355/eurrev_202101_24618

OBJECTIVE: Nocardia kroppenstedtii was isolated from the spinal vertebral abscess of a 78-year-old patient presenting with mid-thoracic pain and bilateral lower limb weakness and numbness. The patient was on long-term immunosuppressive therapy with steroids for underlying autoimmune hemolytic anemia. Investigations showed a T5 pathological fracture and vertebra plana with the erosion of the superior and inferior endplates. There was evidence of paraspinal collection from the T4-T6 vertebrae with an extension into the spinal canal. Analysis of Nocardia 16S rRNA (99.9%, 1395/1396 nt) and secA1 gene (99.5%, 429/431 nt) fragments showed the highest sequence similarity with Nocardia kroppenstedtii type strain (DQ157924), and next with Nocardia farcinica (Z36936). The patient was treated with intravenous carbapenem and oral trimethoprim-sulfamethoxazole for four weeks, followed by another six months of oral trimethoprim-sulfamethoxazole. Despite the improvement of neurological deficits, the patient required assistive devices to ambulate at discharge. This study reports the first isolation of N. kroppenstedtii from the spinal vertebral abscess of a patient from Asia. Infections caused by N. kroppenstedtii may be underdiagnosed as the bacterium can be misidentified as N. farcinica in the absence of molecular tests in the clinical laboratory.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune/drug therapy; Anemia, Hemolytic, Autoimmune/microbiology

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, Autoimmune

Fulltext The co-existence of pure red cell aplasia and autoimmune haemolytic anaemia in a child with malignant lymphoma

Ahmed SA, Hassan R

Malays J Med Sci, 2005 Jul;12(2):56-9.

PMID: 22605959 MyJurnal

The association between pure red cell aplasia (PRCA) and autoimmune haemolytic anaemia (AIHA) has rarely been reported. PRCA represents an isolated process, characterized by normochromic, normocytic anaemia, reticulocytopenia and erythroid hypoplasia in the bone marrow, and may be attributable to infection with Parvo virus B19. AIHA is a condition in which peripheral red blood cell destruction is induced by the presence of autoantibodies. However, the co-existence of these conditions is very rare, since only few cases of PRCA and AIHA associated with malignant lymphoma (ML) were reported. A case of PRCA and AIHA was detected and described, for the first time in Malaysia, in a 10-year-old child suffering from non-Hodgkin lymphoma from the Department of Haematology, Universiti Sains Malaysia. Following the induction course of chemotherapy, the patient turned anaemic, with tendency for red cell clumping, reticulocytopenia and anisocytosis. AIHA was suspected in spite of the weak Coomb reaction obtained. The bone marrow aspirate revealed the presence of giant pronormoblasts, suggesting PRCA. Serological tests for Parvo virus and other viruses were negative.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune

Fulltext An interesting case of systemic lupus erythematosus presenting with hypercalcemia: A diagnostic dilemma

Abdul Gafor AH, Cader RA, Das S, Masir N, Wahid FA

Am J Case Rep, 2013;14:1-3.

PMID: 23569551 DOI: 10.12659/AJCR.883849

BACKGROUND: Hypercalcemia is common in primary hyperparathyroidism malignancies and even in tuberculosis. Interestingly, systemic lupus erythematosus (SLE) rarely presents with hypercalcemia.
CASE REPORT: We describe an interesting case of SLE in a patient who was otherwise thought to have either tuberculosis or a malignancy. The patient initially presented with feeling unwell, with generalized lymphadenopathy, bilateral pleural effusion, and bilateral corneal calcium deposits secondary to severe hypercalcemia. The diagnosis of SLE was made based on positivity of antinuclear antibodies (ANA) and anti-dsDNA, the presence of serositis, lymphadenopathy, autoimmune hemolytic anemia, and constitutional symptoms. She was treated with steroids, with tremendous improvement in her general well-being, resolution of lymphadenopathy and pleural effusion, and normalization of her hemoglobin and serum calcium. The atypical presentation of SLE with hypercalcemia with pleural effusion is discussed.
CONCLUSIONS: SLE should be one of the differential diagnoses in patients presenting with severe hypercalcemia.
KEYWORDS: atypical presentation; hypercalcemia; systemic lupus erythematosus

Matched MeSH terms: Anemia, Hemolytic, Autoimmune

Fulltext Cerebral venous thrombosis in evan’s syndrome: an unusual presentation

Cheng, M.H., Norzila, T.A.B.

International Medical Journal Malaysia, 2016;15(2):85-87.

MyJurnal

Cerebral Venous Thrombosis in patients with Evan’s Syndrome of autoimmune hemolytic anemia is rare. The
common neurological symptoms are headaches, vision loss, dyslexia without agraphia, motor aphasia,
unilateral upper limb weakness and papilloedema. We present a case report of a lady with a known case of
Evan’s Syndrome whom presented with severe anemia and unilateral right sided hemiparesis with right facial
weakness. Plain and Contrast enhanced CT brain showed bilateral high parietal white matter edema with
venous thrombosis in the right transverse and superior sagittal venous sinuses. At the time of the diagnosis,
she was in hematological remission.

Matched MeSH terms: Anemia, Hemolytic, Autoimmune

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