Öz
Autoimmune hemolytic anemia (AIHA) is a disease that is seen in 1/10.000 people and characterized by forming antibodies against red blood cells and degradation of these red blood cells in reticuloendothelial system. Even autoimmune diseases can accompany, it is seen usually idiopathic. Paleness due to anemia, jaundice, tachycardia, darkening in urine color, hepatosplenomegaly are frequently seen clinical findings. Clinically normochrome and normocytic anemia, reticulocytosis, polychromasia in peripheral smear, spherocytes, indirect hyperbilirubinemia and increased lactate dehydrogenase are seen. Direct coombs test is the diagnostic test. Steroids are the first line drugs in treatment. The dosage and the treatment duration is formed according to patient’s clinical situation. The treatment is checked by complete blood count, reticulocyte and Coombs test. Immunosuppressor treatments are given to patients that don’t respond to treatment in 4-6 weeks or less patients who has recurrence at the time of decreasing the treatment dosage of corticosteroids. In few patient, that did not respond steroids, immunosuppressive treatments are used. Here, we present a patient, who is diagnosed with AIHA that we couldn’t manage remission by steroid treatment, and no response to rituxumab as an immunosuppressor, but treated successfully with microphenolat mofetil.
Anahtar Kelimeler
Kaynakça
- 1. Lanzkowsky P. Extracorpuscular Hemolytic Anemia. In: Lanzkowsky P. *Manual of Pediatric Hematology and Oncology*. 5th ed. USA: Elsevier, 2011: 247-56.
- 2. Gehrs BC, Friedberg RC. Autoimmune Hemolytic Anemia. *American Journal of Hematology* 2002; 69: 258-71.
- 3. Sève P, Bourdillon L, Sarrot-Reynauld F. Autoimmune hemolytic anemia and common variable immunodeficiency: a case-control study of 18 patients. *Medicine (Baltimore)* 2008; 87: 177.
- 4. Aladjidi N, Leverger G, Leblanc T. New insights into childhood autoimmune hemolytic anemia: a French national observational study of 265 children. *Haematologica* 2011; 96: 655.
- 5. Liesveld JL, Rowe JM, Lichtman MA. Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. *Blood* 1987; 69: 820.
- 6. Garraty G. Immune hemolytic anemia associated with drug therapy. *Blood Rev* 2010; 24: 143-50.
- 7. Collins PW, Newland AC. Treatment modalities of autoimmune blood disorders. *Semin Hematol* 1992; 29: 64-74.
- 8. Gobert D, Bussel JB, Cunningham-Rundles C. Efficacy and safety of rituximab in common variable immunodeficiency-associated immune cytopenias: a retrospective multicentre study on 33 patients. *Br J Haematol* 2011; 155: 498-508.
- 9. Zimmer-Molsberger B, Knauf W, Tiel E. Mycophenolate mofetil for severe autoimmune haemolytic anemia. *Lancet* 1997; 350: 1003-4.
- 10. Zaja F, Iacona I, Masolini P. B cell depletion with rituximab as treatment for immune hemolytic anemia and chronic thrombocytopenia. *Haematologica* 2002; 87: 189-95.
- 11. Barros MMO, Blajchman MA, Bordin JO. Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and the treatment. *Transfus Med Rev* 2010; 24: 195-21.
Öz
Kaynakça
- 1. Lanzkowsky P. Extracorpuscular Hemolytic Anemia. In: Lanzkowsky P. *Manual of Pediatric Hematology and Oncology*. 5th ed. USA: Elsevier, 2011: 247-56.
- 2. Gehrs BC, Friedberg RC. Autoimmune Hemolytic Anemia. *American Journal of Hematology* 2002; 69: 258-71.
- 3. Sève P, Bourdillon L, Sarrot-Reynauld F. Autoimmune hemolytic anemia and common variable immunodeficiency: a case-control study of 18 patients. *Medicine (Baltimore)* 2008; 87: 177.
- 4. Aladjidi N, Leverger G, Leblanc T. New insights into childhood autoimmune hemolytic anemia: a French national observational study of 265 children. *Haematologica* 2011; 96: 655.
- 5. Liesveld JL, Rowe JM, Lichtman MA. Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. *Blood* 1987; 69: 820.
- 6. Garraty G. Immune hemolytic anemia associated with drug therapy. *Blood Rev* 2010; 24: 143-50.
- 7. Collins PW, Newland AC. Treatment modalities of autoimmune blood disorders. *Semin Hematol* 1992; 29: 64-74.
- 8. Gobert D, Bussel JB, Cunningham-Rundles C. Efficacy and safety of rituximab in common variable immunodeficiency-associated immune cytopenias: a retrospective multicentre study on 33 patients. *Br J Haematol* 2011; 155: 498-508.
- 9. Zimmer-Molsberger B, Knauf W, Tiel E. Mycophenolate mofetil for severe autoimmune haemolytic anemia. *Lancet* 1997; 350: 1003-4.
- 10. Zaja F, Iacona I, Masolini P. B cell depletion with rituximab as treatment for immune hemolytic anemia and chronic thrombocytopenia. *Haematologica* 2002; 87: 189-95.
- 11. Barros MMO, Blajchman MA, Bordin JO. Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and the treatment. *Transfus Med Rev* 2010; 24: 195-21.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Çocuk Hematolojisi ve Onkolojisi, Çocuk Metabolizma Hastalıkları |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 19 Sayı: 1 |