A case presentation of hemolytic anemia in ulcerative colitis and review of the literature.

Autoimmune hemolytic anemia associated with ulcerative colitis is a rare occurrence, and its management poses a therapeutic dilemma. Herein we present a case of ulcerative colitis involving an autoimmune hemolytic anemia and discuss the proposed mechanisms for the anemia. A review of past reported cases and their outcomes is included. In the past, a patient with autoimmune anemia unresponsive to corticosteroids was subjected first to splenectomy and then to colectomy if splenectomy failed to resolve the anemia. In view of the high failure rate for splenectomy, we recommend that ulcerative colitis patients with anemia unresponsive to corticosteroids proceed directly to total colectomy.