Department of Internal Medicine, UPMC Pinnacle, Harrisburg, PA, USA.
Am J Case Rep. 2021 Dec 12;22:e932965. doi: 10.12659/AJCR.932965.
BACKGROUND Autoimmune hemolytic anemia is an acquired disorder resulting in the presence of antibodies against red blood cell (RBC) antigens causing hemolysis. Autoimmune hemolytic anemia is of 2 types, Warm antibody mediated and cold agglutinin disease. Warm autoimmune hemolytic anemia (warm agglutinin disease) usually presents with fatigue and other constitutional symptoms and is diagnosed by the presence of IgG antibodies. The disease can occur as idiopathic or secondary to other autoimmune diseases, infections, or even malignancies. The systemic lupus erythematosus (SLE) is an autoimmune disease prevalent in young females. Autoimmune hemolytic anemia can occur as a part of the SLE spectrum however warm autoimmune hemolytic anemia as the initial manifestation of SLE is extremely rare. CASE REPORT Here, we describe a unique case of a 32-year-old woman who presented with vague clinical presentation found to have warm autoimmune hemolytic anemia and further immunological and inflammatory work-up during and after hospitalization lead to the diagnosis of systemic lupus erythematosus. CONCLUSIONS The systemic lupus erythematosus (SLE) is an autoimmune chronic inflammatory disease with unclear etiology affecting multi organs. Variable presentation in addition to the lack of definite pathognomonic features or tests makes the diagnosis of SLE challenging. On the whole autoimmune hemolytic anemia can not only be part of other disease processes but can be an initial presentation, highlighting the importance of thorough work-up in patients presenting with autoimmune hemolytic anemia to aid in timely diagnosis and management of underlying secondary conditions. It is important for providers to be aware of various disease spectrums that contain autoimmune hemolytic anemia for day-to-day clinical practice.
自身免疫性溶血性贫血是一种后天获得性疾病，导致针对红细胞 (RBC) 抗原的抗体产生，从而引起溶血。自身免疫性溶血性贫血有 2 种类型，温抗体介导型和冷凝集素病。温自身免疫性溶血性贫血（温抗体病）通常表现为疲劳和其他全身症状，并通过 IgG 抗体的存在来诊断。该疾病可表现为特发性或继发于其他自身免疫性疾病、感染，甚至恶性肿瘤。系统性红斑狼疮 (SLE) 是一种常见于年轻女性的自身免疫性疾病。自身免疫性溶血性贫血可作为 SLE 谱的一部分发生，但温自身免疫性溶血性贫血作为 SLE 的初始表现极为罕见。
在这里，我们描述了一个独特的 32 岁女性病例，她表现出模糊的临床症状，被发现患有温自身免疫性溶血性贫血，在住院期间和住院后进行进一步的免疫和炎症检查，导致了系统性红斑狼疮的诊断。
系统性红斑狼疮 (SLE) 是一种病因不明的自身免疫性慢性炎症性疾病，影响多个器官。除了缺乏明确的特征性或检测方法外，多变的表现使得 SLE 的诊断具有挑战性。总的来说，自身免疫性溶血性贫血不仅可以是其他疾病过程的一部分，还可以是初始表现，强调了对出现自身免疫性溶血性贫血的患者进行彻底检查的重要性，以帮助及时诊断和治疗潜在的继发性疾病。对于医疗服务提供者来说，了解包含自身免疫性溶血性贫血的各种疾病谱对于日常临床实践非常重要。
