Coombs-positive autoimmune hemolytic anemia complicating ulcerative colitis. A case report.
We report the case of a 41-year-old woman with a 5-year history of left-sided ulcerative colitis easily controlled by sulfasalazine. She was admitted because of severe anemia, in the absence of any exacerbation of the colitis. A Coombs-positive (IgG type) hemolytic anemia was diagnosed and high-dose corticosteroid therapy was started, which proved to be unsuccessful. A splenectomy was then performed but the hemolytic anemia failed to subside. The patient was subsequently treated with a corticosteroid-azathioprine association with a sustained favourable effect on the anemia. The prevalence and pathophysiology of hemolytic anemia in ulcerative colitis is reviewed and a specific therapeutic approach is proposed.
Martinez
P
P
Division of General Internal Medicine, Saint-Luc University Hospital, Brussels, Belgique.
Lambert
M
M
Vanheuverzwyn
R
R
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D001379:Azathioprine / Q000008:administration & dosage; D003093:Colitis, Ulcerative / Q000150:complications*; D003298:Coombs Test; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000302:isolation & purification; D008775:Methylprednisolone / Q000008:administration & dosage
D007074:Immunoglobulin G; D001379:Azathioprine; D008775:Methylprednisolone