title: Splenic infarction in a patient with autoimmune hemolytic anemia and protein C deficiency.
abstract: Splenic infarction is most commonly caused by cardiovascular thromboembolism; however, splenic infarction can also occur in hematologic diseases, including sickle cell disease, hereditary spherocytosis, chronic myeloproliferative disease, leukemia, and lymphoma. Although 10% of splenic infarction is caused by hematologic diseases, it seldom accompanies autoimmune hemolytic anemia (AIHA). We report a case of a 47-year-old woman with iron deficiency anemia who presented with pain in the left upper abdominal quadrant, and was diagnosed with AIHA and splenic infarction. Protein C activity and antigen decreased to 44.0% (60-140%) and 42.0% (65-140%), respectively. Laboratory testing confirmed no clinical cause for protein C deficiency, such as disseminated intravascular coagulation, sepsis, hepatic dysfunction, or acute respiratory distress syndrome. Protein C deficiency with splenic infarction has been reported in patients with viral infection, hereditary spherocytosis, and leukemia. This is a rare case of splenic infarction and transient protein C deficiency in a patient with AIHA.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors.forename: Min Yong
authors.initials: MY
authors.lastname: Park
authors.forename: Jung A
authors.initials: JA
authors.lastname: Kim
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Yi
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Chang
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Um
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Lee