Autoimmune Hemolytic Anemia after Intravenous Immunoglobulin Therapy in a Child with Kawasaki Disease
10.15264/cpho.2016.23.2.162
- Author:
Joung Whan MOON
1
;
Seung Hyun LEE
;
Yeon Kyun OH
;
Du Young CHOI
;
Seung Taek YU
Author Information
1. Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea. yudoc@wonkwang.ac.kr
- Publication Type:Case Report
- Keywords:
Autoimmune hemolytic anemia;
Kawasaki disease;
Intravenous immunoglobulins
- MeSH:
Anemia;
Anemia, Hemolytic, Autoimmune;
Aneurysm;
Bilirubin;
Child;
Coombs Test;
Coronary Vessels;
Dilatation;
Echocardiography;
Haptoglobins;
Heart Diseases;
Hematocrit;
Humans;
Immunization, Passive;
Immunoglobulins;
Immunoglobulins, Intravenous;
L-Lactate Dehydrogenase;
Mucocutaneous Lymph Node Syndrome;
Prednisolone;
Reticulocytes;
Systemic Vasculitis
- From:Clinical Pediatric Hematology-Oncology
2016;23(2):162-166
- CountryRepublic of Korea
- Language:English
-
Abstract:
Kawasaki disease (KD) can cause acquired heart disease and systemic vasculitis in children. It is treated with intravenous immunoglobulin (IVIG). A significant complication is development of coronary artery lesions such as dilatations or aneurysms. However, uncommon complications can occur, like autoimmune hemolytic anemia when IVIG is used. We present a case of autoimmune hemolytic anemia associated with KD. Dilatation of right coronary artery was found at echocardiography and he was treated twice with IVIG (2 g/kg) with interval of 48 hours. Laboratory finding showed hemoglobin 7.1 g/dL, hematocrit 20.8%, corrected reticulocyte 5.86%, total bilirubin 0.29 mg/dL, lactate dehydrogenase 425 IU/L, and haptoglobin 5 mg/dL. Normocytic, normochromic anemia with anisopoikilocytosis was found on peripheral blood smear, and direct antiglobulin test was positive. The patient was started on oral prednisolone for 3 weeks, with which all symptoms resolved. We report this rare case, prompting consideration of IVIG associated complications when treating KD.
