Fatal disseminated intravascular coagulation and pulmonary thrombosis following blood transfusion in a patient with severe autoimmune hemolytic anemia and human immunodeficiency virus infection.
BACKGROUND
Autoimmune hemolytic anemia (AIHA) has rarely been reported in association with human immunodeficiency (HIV) infection and never as a presenting manifestation. Similarly, disseminated intravascular coagulation (DIC) is a very infrequent complication of HIV infection.


METHODS
An unusual patient is described who at the time of presentation with severe AIHA was found to be HIV positive. Shortly thereafter, he developed DIC, pulmonary thrombi, and right heart failure that proved fatal, in spite of intensive supportive measures.


CONCLUSIONS
Although the etiology of the DIC and pulmonary thrombi could not be established, they are most likely related to aggressive transfusion therapy, with associated intravascular hemolysis.
Bilgrami
S
S
Division of Hematology-Oncology, University of Connecticut Health Center, Farmington.
Cable
R
R
Pisciotto
P
P
Rowland
F
F
Greenberg
B
B
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000628:therapy*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000473:pathology; D008297:Male; D010314:Partial Thromboplastin Time; D010949:Plasma; D017713:Platelet Transfusion; D011517:Prothrombin Time; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology; D065227:Transfusion Reaction