Successful Management of Severe and Refractory Autoimmune Hemolytic Anemia (AIHA) in a Sickle Cell Disease Patient With Bortezomib.

Autoimmune hemolytic anemia (AIHA) is a multifactorial disease that causes immune-mediated red blood cell destruction, resulting in anemia and hemolysis symptoms. Despite a significant understanding of its pathogenesis, the precise causes of AIHA remain largely unclear and are thought to be multifactorial. In this paper, we presented a case of sickle cell anemia who developed severe AIHA that failed to maintain response to multiple treatment lines, including steroids, intravenous immunoglobulin, rituximab, and immune suppressive medications. However, a favorable response was achieved through the utilization of bortezomib. This report contributes to the expanding body of evidence regarding the efficacy of proteasome inhibitors in the management of severe and refractory autoimmune hemolysis in patients with sickle cell anemia.