J Korean Med Sci.  2002 Oct;17(5):708-711. 10.3346/jkms.2002.17.5.708.

Autoimmune Hemolytic Anemia Predominantly Associated with IgA Anti-E and Anti-c

• Lim YA
• Kim MK
• Hyun BH

• KMID: 1127269
• DOI: http://doi.org/10.3346/jkms.2002.17.5.708

Abstract

A patient with warm autoimmune hemolytic anemia (AIHA) due to predominance of immunoglobulin A (IgA) with an Rh specificity, considered to be the first case in Korea, is described. A 13-yr-old male patient with severe hemolytic anemia showed a weak reactivity (1+) in the direct antiglobulin test (DAT) by using anti-IgG antiglobulin reagent. This finding, however, could not fully explain the patient's severe AIHA. When anti-IgA reagent was used for the DAT, strong reactivity (4+) was observed and free anti-E and anti-c autoantibodies were also detected by anti-IgA and anti-IgG reagents. The patient's hemoglobin began to rise with the administration of steroids. Because RBCs coated with multiple types of immunoglobulins are associated with more severe hemolysis than those only with IgG, the DATs using anti-IgA and other reagents are needed for the correct diagnosis when the result of DAT is not compatible with patient's clinical manifestations.

Keyword

Anemia; Hemolytic; Autoimmune; Direct Antiglobulin Test; Anti-IgA

MeSH Terms

Adolescent
Anemia, Hemolytic, Autoimmune/diagnosis/*immunology
Antibody Specificity
Autoantibodies/*blood
Coombs' Test
Humans
Immunoglobulin A/*blood
Korea
Male
Rh-Hr Blood-Group System/immunology