COVID-19-Associated severe autoimmune hemolytic anemia: A rare case report

• Published in: Saudi journal of medicine and medical sciences Vol. 9; no. 3; pp. 276 - 279
• Main Authors: Nair, Lakshmi, Regukumar, Aravind, Baalamurugan, K
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-09-2021; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Asthma; autoimmune hemolytic anemia; Case Report; covid-19; Health aspects; hemolysis; Hemolytic anemia; Infection; sars-cov-2; warm antibody; COVID-19; Autoimmune hemolytic anemia; SARS-COV-2; warm antibody; hemolysis
• ISSN: 1658-631X; 2321-4856
• DOI: 10.4103/sjmms.sjmms_203_21

Autoimmune hemolytic anemia (AIHA) is a very rare presentation of COVID-19, and AIHA due to COVID-19 alone (i.e., in the absence of an associated underlying disorder) is extremely rare. Warm agglutinin disease accounts for the majority of AIHA in general. Here, we report a case of a 23-year-old male with bronchial asthma who was referred to our hospital with SARS-COV-2 infection and severe anemia presenting as acute immune-mediated hemolytic crisis due to warm autoimmune hemolytic anemia (AIHA). Extensive laboratory testing was performed, including polyspecific direct antiglobulin test, complete autoimmune workup and common infections leading to AIHA were ruled out by serology and molecular methods. The patient required multiple blood transfusions and other therapeutic interventions before clinical stabilization. Treatment of new-onset AIHA is always challenging in the presence of an active viral replication; combining immunosuppression with active COVID-19 infection creates extremely difficult diagnostic and management settings, as this case illustrates.