Zhou Y, Ding YL, Zhang LJ, Peng M, Huang J. Direct antiglobulin test-negative autoimmune hemolytic anemia in a patient with β-thalassemia minor during pregnancy: A case report. World J Clin Cases 2022; 10(4): 1388-1393 [PMID: 35211574 DOI: 10.12998/wjcc.v10.i4.1388]
Corresponding Author of This Article
Jian Huang, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. huangjian2566@126.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2022; 10(4): 1388-1393 Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1388
Direct antiglobulin test-negative autoimmune hemolytic anemia in a patient with β-thalassemia minor during pregnancy: A case report
Yang Zhou, Yi-Ling Ding, Li-Juan Zhang, Mei Peng, Jian Huang
Yang Zhou, Yi-Ling Ding, Li-Juan Zhang, Mei Peng, Jian Huang, Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
Author contributions: Zhou Y reviewed the literature and contributed to manuscript drafting; Ding YL and Peng M were responsible for making critical revisions related to important intellectual content of the manuscript; Zhang LJ and Huang J were the patient’s obstetricians, and responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Huang, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. huangjian2566@126.com
Received: September 4, 2021 Peer-review started: September 4, 2021 First decision: November 22, 2021 Revised: November 27, 2021 Accepted: December 25, 2021 Article in press: December 25, 2021 Published online: February 6, 2022
Abstract
BACKGROUND
Severe refractory anemia during pregnancy can cause serious maternal and fetal complications. If the cause cannot be identified in time and accurately, blind symptomatic support treatment may cause serious economic burden. Thalassemia minor pregnancy is commonly considered uneventful, and the condition of anemia rarely progresses during pregnancy. Autoimmune hemolytic anemia (AIHA) is rare during pregnancy with no exact incidence available.
CASE SUMMARY
We report the case of a 30-year-old β-thalassemia minor multiparous patient experiencing severe refractory anemia throughout pregnancy. We monitored the patient closely, carried out a full differential diagnosis, made a diagnosis of direct antiglobulin test-negative AIHA, and treated her with prednisone and intravenous immunoglobulin. The patient gave birth to a healthy full-term baby.
CONCLUSION
Coombs-negative AIHA should be suspected in cases of severe hemolytic anemia in pregnant patients with and without other hematological diseases.
Core Tip: Severe maternal anemia can cause serious adverse effects with a significant increase in maternal and neonatal mortality. We report the successful diagnosis and treatment of direct antiglobulin test test-negative autoimmune hemolytic anemia in a patient with β-thalassemia minor during pregnancy. The findings from this case report suggest that maternal anemia can have multiple etiologies, and blood transfusion is not always the appropriate treatment.
