Elderly female with Autoimmune hemolytic anemia

Elderly female with Autoimmune hemolytic anemia

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Autoimmune hemolytic anemia (AIHA) is a rare disease with an estimated prevalence of around 17/100,000.It is often difficult to diagnose and treat AIHA, especially in elderly.A 60-year-old female was admitted with the complaints of low grade fever, on-off for 6 months, progressive fatigue and dyspnea on exertion.She was transfused with three units of blood within these Short Wellingtons 6 months.

Examination revealed pallor, edema, hemic murmur, and palpable liver.Hb was 2.9 gm%, T Bil 5.2 mg/dl, ESR 160 mm, and reticulocyte count 44.

05%.Direct Coombs test was positive, anti-nuclear antibody (ANA) and Anti ds DNA were positive.A diagnosis of systemic lupus erythematosus (SLE) with AIHA was considered and patient was transfused with two units of packed red cells and put on steroid (prednisolone) at 1 mg/kg body weight daily.After 3 weeks, SMA Plug to FME her Hb had increased to 10.

4 gm% with gross clinical improvement.