A Case of Autoimmune Hemolytic Anemia Caused by Anti-D and Anti-C in RhD Positive Patient / 대한수혈학회지

ABSTRACT

We report a case of autoimmune hemolytic anemia caused by anti-D and anti-C in an RhD positive patient with Epstein-Barr Virus (EBV) infection. The patient achieved complete response by transfusion, treatment with a cytotoxic drug and plasmapheresis. A 66-year-old male patient visited the local hospital for exertional dyspnea. Incompatible crossmatching resulted in the transfer of the patient to our institution for transfusion. Anti-D, C were identified as the autoantibodies causing hemolytic anemia by the use of a direct antiglobulin test, antibody screening test, adsorption and elusion test, and antibody titration in the serum and eluate. The auto IgG warm antibodies were thought to be associated with the EBV infection. This case demonstrates the importance of performing antibody screening and an identification test for transfusion. Transfusion in autoimmune hemolytic anemia is complicated by the presence of pan reactive IgG autoantibodies. However, in this case,the autoantibody was specific for a defined blood group, RhD and RhC antigens,and serocompatible blood was administered without difficulty. Not only transfusion, but also treatment with steroids, a cytotoxic drug and plasmapheresis were critical in the treatment of autoimmune hemolytic anemia.