Abstract
Abstract Autoimmune hemolytic anemia (AIHA) is a rare disorder characterized by antibodies against one’s own red blood cells, often difficult to diagnose and treat in the elderly. It can be secondary to an infection, drug, or a myeloproliferative disorder. We report a rare case of tuberculosis (TB)-induced AIHA in an older woman. A 70-year-old woman complained of progressive weakness, weight loss, and abdominal pain over 6 months. Examination revealed anemia, jaundice, and splenomegaly. Routine blood investigations showed pancytopenia and Coombs test that was positive for autoantibodies. Workup for autoimmune disease like systemic lupus erythematosis was negative. Lymphoma, disseminated TB, and lymphoproliferative disorders were considered. Bone marrow biopsy was reported as normal. Mycobacterium tuberculosis was isolated from the bronchoalveolar lavage. A diagnosis of autoimmune hemolytic anemia secondary to disseminated TB was made. She was treated with steroids and antitubercular therapy, which improved her health and laboratory parameters. A positron emission tomography–computed tomography showed the resolution of splenic lesions and reduced metabolic activity of mediastinal and abdominal lymph nodes.
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