Part 1: Autoimmune Hemolytic Anemia

Thomas G. DeLoughery, MD

Professor of Medicine, Pathology, and Pediatrics, Division of Hematology/Medical Oncology,
Departments of Medicine and Pediatrics, and Division of Laboratory Medicine, Department of
Pathology, Oregon Health Sciences University, Portland, OR

Question 2

A 78-year-old woman who has developed severe anemia but is otherwise healthy presents for evaluation. Her past history is unremarkable. Physical exam reveals shotty nodes but is otherwise normal. Laboratory testing shows a hematocrit of 19%, an elevated LDH concentration that is twice the upper limit of normal, and a reticulocyte count (corrected) of 3%. Her DAT is negative for IgG but positive for C3. What is the treatment of choice for her hemolysis?

  •   Danazol 200 mg 4 times daily
  •   Intravenous immunoglobulin 1 g/kg
  •   Prednisone 1 mg/kg daily
  •   Rituximab at 375 mg/m2 weekly × 4 weeks
  •   Splenectomy

Updated 05/24/2013 • jdw | Copyright ©2014 Turner White Communications