Autoimmune Hemolytic Anemia Caused by Cold Agglutinin Antibodies in Systemic Lupus erythematosus—a Rare Association: Case Report

Abstract

Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas cold antibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient with systemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology and hematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severe hematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinical suspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timely diagnosis and provide optimal therapy.

Keywords:

• autoimmune hemolytic anemia
• systemic lupus erythematosus
• autoimmune diseases
• antibodies

Abbreviations

AIHA, autoimmune hemolytic anemia; SLE, systemic lupus erythematosus; IgM, immunoglobulin M.

Acknowledgments

The research team’s activities were sponsored by Clínica de Occidente S.A. and the Universidad Santiago de Cali. However, the authors declare full autonomy when conducting all phases of the study.

Disclosure

Dr Giovanna Patricia Rivas-Tafurt reports personal fees from Amgen and Bristol Myers Squibb, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

This research has been funded by Dirección General de Investigaciones of Universidad Santiago de Cali under call No. 02-2023.