Secondary autoimmune hemolytic anemia in patients with tuberculosis: a report of 4 cases

Abstract

Medical charts of tuberculotic patients with secondary autoimmune hemolytic anemia (AIHA) admitted to Peking Union Medical College Hospital(PUMCH)from 2006 to 2015 were retrospectively reviewed. Four cases with complete information of laboratory tests, imaging findings and bone marrow results were included. Therapy regimens and outcomes of survival were followed by phone call if needed. Ages at diagnosis of AIHA were 58-80 years old, hemoglobin levels were 31-73 g/L, Coomb tests were negative in all cases. Therapy of cortical steroid did not work, while anti-TB therapy (including isoniazid, rifampicin, ethambutol) significantly improved hemoglobin to normal level in three cases during six to nine months. One case died within one week, for progressive TB to central neurological system. As one of rare complications of TB, AIHA may be fatal. Early diagnosis and appropriately anti-TB therapy is helpful for good outcomes. Key words: Tuberculosis; Anemia, hemolytic, autoimmune