Direct antiglobulin test negative autoimmune hemolytic anemia associated with autoimmune hepatitis.
A case of direct antiglobulin test(DAT)-negative autoimmune hemolytic anemia (AIHA) associated with autoimmune hepatitis (AIH) is presented. A 54-year-old female was admitted with liver dysfunction and anemia. AIH was diagnosed based on the diagnostic criteria of the International Autoimmune Hepatitis Group. The patient was DAT-negative, and exhibited all the clinical features of warm type AIHA and elevated levels of red blood cell-associated IgG. Marked improvement of subjective symptoms, the return to normal of hematological and liver test values, and a decrease in the level of RBC-associated IgG were observed after the start of corticosteroid therapy. Although an association of AIH and AIHA is rarely reported, the measurement of RBC-associated IgG is recommended in cases of AIH with DAT-negative anemia, as both disorders are autoimmune in nature.
Kondo
H
H
Department of Medicine, Shimizu Kosei Hospital, Shizuoka, Japan. haruki_kondo@msn.com
Kajii
E
E
Oyamada
T
T
Kasahara
Y
Y
D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000276:immunology*; D003298:Coombs Test; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008875:Middle Aged
D007074:Immunoglobulin G