Korean J Blood Transfus.  2000 Dec;11(2):177-181.

A Case of Autoimmune Hemolytic Anemia Induced by Autoanti-E

• Kim SY

Abstract

Autoimmune hemolytic anemia was diagnosed in a 60-year-old male without underlying disorder. He had complained of headache and exertional dyspnea. Laboratory studies revealed hemoglobin 4.9 g/dL, reticulocyte count 30%, total serum bilirubin 2.6 mg/dL, and haptoglobin 10 mg/dL. The peripheral blood smear showed marked spherocytosis. The bone marrow examination showed marked erythroid hyperplasia. The direct antiglobulin test was 2+ positive with anti-IgG and negative for C3d while indirect antiglobulin test was 1+ positive. The anti-E was identified in his serum and eluate from his red blood cells (RBCs). His blood group was group A, CcDEe. He had no transfusion history and autocontrol was positive. The adsorbed serum with ZZAP-treated RBCs did not react with a panel of reagent RBCs. These findings indicated that the antibody was autoanti-E. After transfusions of E-negative RBCs, the hemoglobin increased to 8.4 g/dL, and hemolytic transfusion reaction was not noted after transfusions. Treatment with prednisolone was effective in controlling the hemolytic anemia, but a splenectomy was performed to achieve permanent remission. After splenectomy the patient had normal hemoglobin and reticulocyte count lasting for three years without subsequent medical therapy.

Keyword

Autoimmune hemolytic anemia; Autoanti-E

MeSH Terms

Anemia, Hemolytic
Anemia, Hemolytic, Autoimmune*
Bilirubin
Blood Group Incompatibility
Bone Marrow Examination
Coombs Test
Dyspnea
Erythrocytes
Haptoglobins
Headache
Humans
Hyperplasia
Male
Middle Aged
Prednisolone
Reticulocyte Count
Splenectomy
Bilirubin
Haptoglobins
Prednisolone