Reversal of autoimmune hemolytic anemia associated with chronic lymphocytic leukemia following high-dose immunoglobulin.
An 85-year-old man with chronic lymphocytic leukemia developed severe warm antibody-type autoimmune hemolytic anemia. Initial therapy with high-dose corticosteroids had no discernible effect on the hemolytic process. Following treatment with high-dose intravenous immunoglobulin (0.4 g/kg/d for 5 consecutive days) there was an immediate and sustained increase in hematocrit accompanied by a progressive decline in reticulocyte count. A review of the literature reveals that some patients with steroid-resistant immune hemolysis may benefit from high-dose immunoglobulin. This approach should be considered in elderly patients with severe anemia whose medical status precludes splenectomy.
Ritch
P S
PS
Department of Medicine, Medical College of Wisconsin, Milwaukee.
Anderson
T
T
D000368:Aged; D000369:Aged, 80 and over; D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy*; D006801:Humans; D007116:Immunization, Passive; D007945:Leukemia, Lymphoid / Q000150:complications*; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D011696:Purpura, Thrombocytopenic / Q000628:therapy
D011241:Prednisone