Warm autoimmune haemolytic anaemia and autoimmune hepatitis in an asymptomatic carrier of hepatitis B virus.
Warm antibody autoimmune haemolytic anaemia, a rare disease (0.2-1 per 100,000 populations), is due to the presence of warm agglutinins that react with protein antigens on the surface of red blood cells causing their premature destruction. Here, we present a case report of a 10 year old girl who came with features of haemolytic anaemia and history of blood transfusion since 3 years. On admission. laboratory test revealed that she had autoimmune hepatitis type 1 and was also an asymptomatic carrier of hepatitis B virus with positive HBs Ag. Steroid therapy resulted in clinical and laboratory remission. Direct antiglobulin test was negative after anaemia resolution, hepatitis B virus antigenemia persisted. To our knowledge, warm antibody autoimmune hemolytic anaemia has not previously been described in association with autoimmune hepatitis and asymptomatic carrier state of hepatitis B virus.
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Saleem
S
Khawaja
Kazi
K
Abdul Muqtadir
Yasmeen
Y
Taj
D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology / Q000628:therapy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D002353:Carrier State; D002648:Child; D003298:Coombs Test; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006514:Hepatitis B Surface Antigens; D006515:Hepatitis B virus / Q000302:isolation & purification; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D006514:Hepatitis B Surface Antigens; D011239:Prednisolone