41anurag Etal
41anurag Etal
41anurag Etal
com
Case report
DOI: 10.5958/2319-5886.2015.00184.8
Open access
ARTICLE INFO
ABSTRACT
th
Senior Resident,
Department of Medicine, Sawai Man
Singh Medical College, Jaipur, India
2
Senior Resident, Department of
Paediatrics, Sawai Man Singh Medical
College, Jaipur, India
Authors details:
author:
Lohmror
Anurag
Senior Resident, Department of
Medicine, Sawai Man Singh Medical
College, Jaipur, India
Email: [email protected]
Corresponding
Autoimmune hemolytic
anemia, Tuberculosis, Cold agglutinin
Keywords:
INTRODUCTION
Autoimmune hemolytic anemia (AIHA) occurs when a
patient produces pathologic antibodies that attach to and
lead to the destruction of their RBCs with consequent
anemia. AIHA can be classified as warm AIHA and cold
AIHA according to the characteristic temperature activity of
[1]
the antibodies . Occasionally, a patient may have mixed
cold and warm active antibodies. Primary (idiopathic) AIHA
[2]
is less frequent than secondary AIHA . Autoimmune
antibodies, particularly cold-reactive antibodies, are
sometimes produced following an infection or immune
[3,4,5,6]
defects or lympho proliferative disorders or drugs
.
These secondary cases are often challenging since not
only AIHA, but also the underlying disease must be
diagnosed and treated. Association of autoimmune
haemolytic anaemia with pulmonary tuberculosis has been
seldom reported. Tuberculosis being a common disease,
the association with hemolytic anemia should be
recognized and treated judiciously.
CASE REPORT
A 25 year old female presented to our department with a
history of fever associated with cough and fatigue. Physical
examination revealed pallor and mild splenomegaly. Blood
pressure, pulse rate and temperature were within normal
limits. Bilateral crepitations could be heard on chest
auscultation. Other findings on physical examination were
unremarkable. There was a past history of receiving blood
transfusion on four occasions. The laboratory investigations
demonstrated severe anemia (Hemoglobin 4.5 g/dl; MCV
74.3fl MCH 18.4pg MCHC 24.7g/dl) with a normal white
911
Anurag et al.,
CONCLUSION
Although rare, pulmonary tuberculosis may be associated
with autoimmune hemolytic anemia. Tuberculosis should be
considered as a differential diagnosis of the etiology of
secondary AIHA because administration of steroids alone
to treat AIHA in such untreated tuberculosis cases may be
detrimental to the patient.
ACKNOWLEDGEMENT: none
Conflict of Interest: Nil
REFERENCES
1.
912
Anurag et al.,