[IgA-mediated auto-immune haemolytic anaemia revealing a hepatitis C virus infection].
BACKGROUND
Confirmation of autoimmune hemolytic anaemia usually relies on the detection of erythrocyte membrane-bound autoantibodies using a direct antiglobulin test. In the rare case of IgA autoantibodies-mediated autoimmune hemolytic anemia, the direct antiglobulin test can be negative, because routinely used polyspecific direct antiglobulin test reagents contain only anti-IgG and anticomplement antibodies.


METHODS
We report the case of a 41-year-old woman presenting a severe autoimmune hemolytic anaemia caused by the presence of warm autoantibodies of IgA type that revealed a chronic hepatitis C virus infection.


CONCLUSIONS
A negative direct antiglobulin test does not completely rule out the diagnosis of autoimmune hemolytic anaemia especially in the rare case of IgA mediated immune hemolysis. The diagnosis strategy of autoimmune hemolytic anaemia associated with negative direct antiglobulin test and the potential links between autoimmune hemolytic anaemia and HCV are discussed.
Grimaldi
D
D
Service de médecine interne, CHU Henri-Mondor, 52, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
Limal
N
N
Noizat-Pirenne
F
F
Janvier
D
D
Godeau
B
B
Michel
M
M
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis* / Q000276:immunology; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D015933:Complement C3d / Q000276:immunology; D003298:Coombs Test; D003937:Diagnosis, Differential; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology
D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015933:Complement C3d