1.IgG4-related diseases with autoimmune hemolytic anemia: A case report.
Manxuan PEND ; Lizhen YANG ; Shangjie WU
Journal of Central South University(Medical Sciences) 2020;45(6):739-744
IgG4-related disease (IgG4-RD) is a rare autoimmune fibrosis disease characterized by elevated serum IgG4 and tissues as well as organs infiltrated with IgG4-positive cells, resulting in swelling and damage.It is currently treated as first-line treatment with glucocorticoids. Autoimmune hemolytic anemia (AIHA) is also a relatively rare disease that caused by autoreactive erythrocyte antibodies. Although both are autoimmune-related diseases, they rarely overlap. The relationship between them is not clear. A case of IgG4-RD combined with AIHA is reported. The patient has shortness of breath, cough, and sputum after physical activity. Physical examination showed appearance of anemia, yellow staining of skin and sclera, palpable neck and multiple swollen lymph nodes. Laboratory examination, bone marrow biopsy, and lymph node biopsy confirmed the diagnosis. Therefore, clinicians should develop ideas and raise awareness of such diseases.
Anemia, Hemolytic, Autoimmune
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diagnosis
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drug therapy
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Autoimmune Diseases
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complications
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Biopsy
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Humans
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Immunoglobulin G
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Immunoglobulin G4-Related Disease
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complications
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diagnosis
2.A Case of Steroid Resistant Autoimmune Hemolytic Anemia in Ulcerative Colitis.
Hyun Jong CHOI ; Su Jin HONG ; Young Jee KIM ; Bong Min KO ; Moon Sung LEE ; Chan Sup SHIM ; Hyun Jung KIM ; Dae Sik HONG
The Korean Journal of Gastroenterology 2008;51(2):137-141
Autoimmunity is thought to play a central role in the pathogenesis of inflammatory bowel disease and associated extraintestinal manifestations. Autoimmune hemolytic anemia associated with ulcerative colitis is a rare occurrence. No more than 50 cases have been described in the international literatures, and only 2 cases reported in Korea. A 29-year-old woman who was diagnosed as ulcerative colitis two years ago was complicated with autoimmune hemolytic anemia, and did not respond to steroid therapy. Ultimately, total colectomy and splenectomy were carried out for the treatment of ulcerative colitis and hemolytic anemia. After the operation, anemia was resolved. We present the case with a review of literature.
Adult
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Anemia, Hemolytic, Autoimmune/*diagnosis/drug therapy/etiology
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Colectomy
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Colitis, Ulcerative/complications/*diagnosis/pathology
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Drug Resistance
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Female
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Humans
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Splenectomy
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Steroids/therapeutic use
3.A Case of Autoimmune Hemolytic Anemia Complicating Hematopoietic Cell Transplantation.
Hyojin CHAE ; Yonggoo KIM ; Myungshin KIM ; Jihyang LIM ; Kyungja HAN ; Seok Goo CHO ; Jong Wook LEE
The Korean Journal of Laboratory Medicine 2008;28(1):64-69
A 32-yr-old male diagnosed with myelodysplastic syndrome underwent an unmanipulated, unrelated, HLA matched, peripheral blood stem cell transplantation. The patient and donor were both blood type O, CcDEe. Twelve weeks post-transplantation, he developed acute autoimmune hemolytic anemia (AIHA). He was transfused multiple times with washed O red cells. High-dose steroid therapy was initiated and he underwent splenectomy; however, AIHA was refractory to therapy. The patient was further treated with combined treatment modalities including immunosuppressive therapy with mycophenolate mofetil and cyclosporine and three cycles of plasma exchange, and AIHA responded to treatment. This is the third case of AIHA complicating hematopoietic stem cell transplantation reported in Korea. Since AIHA is relatively common after hematopoietic stem cell transplantation, accurate and timely diagnosis of the disease and treatment strategies with multiple modalities are necessary.
Adult
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Anemia, Hemolytic, Autoimmune/*diagnosis/drug therapy/etiology
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Combined Modality Therapy
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Cyclosporine/therapeutic use
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Hematopoietic Stem Cell Transplantation/*adverse effects
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Humans
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Male
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Mycophenolic Acid/analogs & derivatives/therapeutic use
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Myelodysplastic Syndromes/complications/diagnosis/therapy
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Plasma Exchange
4.Coinfection of hepatitis A virus genotype IA and IIIA complicated with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive immunoglobulin M anti-hepatitis E virus: a case report.
Hee Sup KIM ; Sook Hyang JEONG ; Je Hyuck JANG ; Hyung Joon MYUNG ; Jin Wook KIM ; Soo Mee BANG ; Sang Hoon SONG ; Haeryoung KIM ; Hae Sun YUN
The Korean Journal of Hepatology 2011;17(4):323-327
A 37-year-old male presented with fever and jaundice was diagnosed as hepatitis A complicated with progressive cholestasis and severe autoimmune hemolytic anemia. He was treated with high-dose prednisolone (1.5 mg/kg), and eventually recovered. His initial serum contained genotype IA hepatitis A virus (HAV), which was subsequently replaced by genotype IIIA HAV. Moreover, at the time of development of hemolytic anemia, he became positive for immunoglobulin M (IgM) anti-hepatitis E virus (HEV). We detected HAV antigens in the liver biopsy specimen, while we detected neither HEV antigen in the liver nor HEV RNA in his serum. This is the first report of hepatitis A coinfected with two different genotypes manifesting with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive IgM anti-HEV.
Adult
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Anemia, Hemolytic, Autoimmune/*diagnosis/drug therapy/etiology
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Anti-Inflammatory Agents/therapeutic use
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Cholestasis/*diagnosis/drug therapy/pathology
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Coinfection/*diagnosis
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Genotype
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Hepatitis A/complications/*diagnosis/genetics
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Hepatitis E/complications/*diagnosis/genetics
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Humans
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Immunoglobulin M/blood
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Liver/pathology/virology
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Male
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Prednisolone/therapeutic use
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RNA, Viral/blood
5.Pure red-cell aplasia and autoimmune hemolytic anemia in a patient with acute hepatitis A.
Hyo Jeong CHANG ; Dong Hyun SINN ; Sung Gyun CHO ; Tae Hoon OH ; Tae Joo JEON ; Won Chang SHIN ; Won Choong CHOI
Clinical and Molecular Hepatology 2014;20(2):204-207
Pure red cell aplasia (PRCA) and autoimmune hemolytic anemia (AIHA) have rarely been reported as an extrahepatic manifestation of acute hepatitis A (AHA). We report herein a case of AHA complicated by both PRCA and AIHA. A 49-year-old female with a diagnosis of AHA presented with severe anemia (hemoglobin level, 6.9 g/dL) during her clinical course. A diagnostic workup revealed AIHA and PRCA as the cause of the anemia. The patient was treated with an initial transfusion and corticosteroid therapy. Her anemia and liver function test were completely recovered by 9 months after the initial presentation. We review the clinical features and therapeutic strategies for this rare case of extrahepatic manifestation of AHA.
Acute Disease
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Adult
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Anemia, Hemolytic, Autoimmune/*complications/*diagnosis/drug therapy
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Antineoplastic Agents, Hormonal/therapeutic use
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Bone Marrow/pathology
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Female
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Hepatitis A/*complications/*diagnosis
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Humans
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Male
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Middle Aged
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Prednisolone/therapeutic use
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Red-Cell Aplasia, Pure/*complications/*diagnosis/drug therapy
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Treatment Outcome
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Young Adult