A case of autoimmune hemolytic anemia diagnosed by occurrence of cardioembolic stroke

Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
Shunsuke KimuraShuji Arakawa

Abstract

A 79-year-old woman came to us because of sudden onset of dysarthria. She had taken apixaban due to her non-valvular atrial fibrillation. A neurological examination revealed mild facial palsy of her right side, and magnetic resonance imaging showed acute brain infarction at the left frontal lobe. There were no stenotic lesions on intracranial or extracranial magnetic resonance angiography, and she was diagnosed with cardioembolic stroke. Intravenous infusion of heparin and edaravone was initiated, and her neurological symptoms improved. However, she gradually developed jaundice and anemia. Gastro-intestinal bleeding was not observed, and her blood test met the diagnostic criteria for hemolytic anemia. Because both the direct Coombs test and cold agglutinin were positive, she was diagnosed with mixed-type autoimmune hemolytic anemia. Although her serum hemoglobin level decreased to 7.0 g/dl on the 12th hospital day, her anemia gradually improved after steroidal therapy with transfusion. It was revealed that she had shown mild anemia (hemoglobin: 9.2-10.9 g/dl) and hyperbilirubinemia (total bilirubin: 1.8-2.6 mg/dl) for 6 months. Therefore, her latent autoimmune hemolytic anemia became activated with the occurrence of cardioembol...Continue Reading

References

Oct 14, 2014·British Journal of Haematology·Camilla L'Acqua, Eldad Hod
May 6, 2015·British Journal of Haematology·Marco Ruggeri, Francesco Rodeghiero
Jul 15, 2015·Autoimmunity Reviews·M Lecouffe-DespretsM Hamidou
Nov 1, 2015·BMC Neurology·Haiqiang JinYunchuang Sun

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