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Grace Boxer
Grace Boxer
Tanzania
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Research Article
Life-Threatening Autoimmune Hemolytic Anemia Treated with Manual Whole Blood Exchange with Rapid Clinical Improvement
Author(s): Laura Cooling, Grace Boxer and Richard SimonLaura Cooling, Grace Boxer and Richard Simon
Severe autoimmune hemolytic anemia, with high titer panagglutinins, can present with severe intra-and extravascular hemolysis, complicated by renal failure, volume overload, hypertriglyceridemia, pancreatitis and multiorgan failure. We present a case of life-threatening warm autoimmune hemolytic anemia in a 19 year old male, refractory to steroids and splenectomy, with ongoing severe hemolysis, in vivo and in vitro autoagglutination, worsening hypoxia, methemoglobinemia, renal insufficiency, and hypertriglyceridemia. The patient underwent a single manual whole blood exchange with reconstituted whole blood (50% final hematocrit). The post-exchange hemoglobin was 7.7 gm/dL, with complete resolution of RBC autoagglutination, increased platelet count (20% ) and marked decreases in plasma free hemoglobin (43%), methemoglobin (9%), percent FiO2 (40%), creatinine (30%), triglycerides (66%), .. View More»
DOI: 10.4172/2155-9864.1000163