Autoimmune hemolytic anemia in ulcerative colitis: report of three cases, review of the literature, and evaluation of modes of therapy.

Three cases of autoimmune hemolytic anemia in association with idiopathic ulcerative colitis are reported; the literature is reviewed; and therapeutic modalities are considered. Successful treatment is shown to have resulted with steroids alone, steroids and immunosuppressives, splenectomy, and colectomy. It is concluded that moderate or severe hemolysis should be treated first with high-dose corticosteriods; if unsuccessful, immunosuppressive therapy may be added or a splenectomy performed. Finally, total colectomy should be reserved for fulminant colitis and its complications and is not indicated solely for hemolysis.