Volume 3, Issue 4, July 2015, Page: 156-159
Successful Rituximab Treatment of Autoimmune Hemolytic Anemia Caused by Both Warm Autoantibodies and Cold Agglutinin: A Case Report
Motoharu Shibusawa, Department of Hematology Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation, Tama-Hokubu Medical Center, Tokyo, Japan
Yoshirou Murai, Department of Hematology Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation, Tama-Hokubu Medical Center, Tokyo, Japan
Hisashi Tsutsumi, Department of Hematology Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation, Tama-Hokubu Medical Center, Tokyo, Japan
Received: Feb. 28, 2015;       Accepted: Mar. 4, 2015;       Published: Jun. 23, 2015
DOI: 10.11648/j.ajim.20150304.12      View  4468      Downloads  99
Abstract
This report describes a case which successfully treated with rituximab against autoimmune hemolytic anemia caused by both warm autoantibodies and cold agglutinin (mixed AIHA). A 52-year-old man with malaise was referred to our hospital in December 2002. A diagnosis of mixed AIHA was made. His clinical course showed that the hemolysis was mainly caused by cold agglutinin, with a possible contribution from the warm autoantibody. He was treated with prednisolone (PSL), Cyclosporine (CyA), and cyclophosphamide (CPA). The treatment with PSL, CyA, and CPA failed to stabilize the hemolysis caused by cold exposure in the winter season. In November 2013 (winter season), rituximab therapy (375 mg/m2 weekly for four weeks) was started, and the hemolysis improved. The present case suggests that rituximab is useful against mixed AIHA. Further studies are warranted to establish the effectiveness of rituximab against mixed AIHA.
Keywords
Autoimmune Hemolytic Anemia, Rituximab, Mixed Autoimmune Hemolytic Anemia
To cite this article
Motoharu Shibusawa, Yoshirou Murai, Hisashi Tsutsumi, Successful Rituximab Treatment of Autoimmune Hemolytic Anemia Caused by Both Warm Autoantibodies and Cold Agglutinin: A Case Report, American Journal of Internal Medicine. Vol. 3, No. 4, 2015, pp. 156-159. doi: 10.11648/j.ajim.20150304.12
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