Autoimmune Hemolytic Anemia in Ulcerative Colitis A Case Report with Review of the Literature

Auto-Immune Haemolytic Anaemia in Ulcerative Colitis: Report of Three Cases

“…At the present time, in agreement with other authors [3][4][5], initially we recommended a conservative approach in AIHA associated to UC. Splenectomy should be per formed on patients whose colitis is inactive or mild and their haemolysis resistant to steroids or other immuno suppressive drugs; total proctocolectomy should be re served for patients not responding to splenectomy and for those who suffer from severe intractable colitis.…”

“…A complete or partial response has been reported in about 40% of patients treated with ste roids [5]. Immunosuppressive drugs associated with ste roids have also been tried.…”

“…Several authors [1,2] suggest that patients unresponsive to steroids should undergo total proctocolectomy directly, even in the absence of active colonic disease. Other au thors [3,5] recommended splenectomy before total colec tomy.…”

Extraintestinal Manifestations of Ulcerative Colitis

“…However, studies have shown that approximately 1.82% of UC patients without signs of hemolysis can have a positive direct Coombs test (Valderrama Rojas, Rodriguez Gorostiza et al, 2003). Systemic steroids are the first line of therapy, produce remission in 21% to 50% of cases, and should be continued for 3 weeks before being considered ineffective (Gumaste, Greenstein et al, 1989;Veloso et al, 1991). For cases unresponsive to steroids, immunosuppressive therapy with agents such as cyclophosphamide or azathioprine and surgical intervention including splenectomy should be considered.…”

Extraintestinale Manifestationen bei chronisch-entz�ndlichen Darmerkrankungen*

“…Besonders die Colitis ulcerosa kann in schweren Fällen auch mit hämolyti-schen Anämien kombiniert sein [4,6,9,25,29,32,34,51,56,57,65,69,72,74,87,103,109,124,127,134,145,146,150,166,171,175,181]. Durch eine Kolektomie lassen sich bei diesen teilweise schweren autoimmunhämolyti-schen Anämien die hämolytischen Krisen vermeiden.…”