COVID‐19 associated with severe autoimmune hemolytic anemia
Open Access
- 3 December 2020
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 61 (2), 635-640
- https://doi.org/10.1111/trf.16226
Abstract
BACKGROUND Autoimmune hemolytic anemia (AIHA) has many known disease associations, including autoimmune, lymphoproliferative, and certain infectious diseases, as well as various medications. Studies have found that severe cases of COVID‐19 may be associated with coagulopathies, however the potential association with AIHA is not clear. CASE REPORT A patient with no known risk factors or underlying predisposition for developing AIHA presented to a hospital with vague symptoms and profound anemia with a complicated blood bank evaluation. She was found to have COVID‐19 and AIHA, for which extensive laboratory testing was performed, including direct antiglobulin tests, elution studies, and cold agglutinin titers, to identify the causative autoantibody. She required multiple blood transfusions and therapeutic interventions prior to clinical stabilization. DISCUSSION AIHA is a complex disease with a spectrum of presentations and clinical severity. Many diseases have been associated with a propensity for developing AIHA, however there are few cases in the literature of patients with COVID‐19 and AIHA. Most of the reports involve patients with other underlying conditions that are known to be associated with the development of AIHA. The presentation, clinical findings, and therapeutic interventions in a patient with severe AIHA, without other underlying conditions, in the setting of COVID‐19 are discussed. CONCLUSION There are few reports of patients with concurrent COVID‐19 and AIHA, and the association is not clear. Although COVID‐19 has been shown to be associated with coagulopathies, more research is required to determine whether AIHA may also be a potential complication.This publication has 11 references indexed in Scilit:
- Autoimmune haemolytic anaemia associated with COVID‐19 infectionBritish Journal of Haematology, 2020
- Simultaneous onset of COVID‐19 and autoimmune haemolytic anaemiaBritish Journal of Haematology, 2020
- ISTH interim guidance on recognition and management of coagulopathy in COVID‐19Journal of Thrombosis and Haemostasis, 2020
- Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumoniaJournal of Thrombosis and Haemostasis, 2020
- Warm Autoimmune Hemolytic AnemiaThe New England Journal of Medicine, 2019
- How I treat autoimmune hemolytic anemiaBlood, 2017
- Autoimmune Hemolytic AnemiaMedical Clinics of North America, 2017
- The Direct Antiglobulin Test: Indications, Interpretation, and PitfallsArchives of Pathology & Laboratory Medicine, 2017
- Cold Agglutinin-Mediated Autoimmune Hemolytic AnemiaHematology/Oncology Clinics of North America, 2015
- Cold agglutinin diseaseBlood, 2013