Case report of mixed-type autoimmune hemolytic anemia in a patient with relapsing polychondritis

Abstract

Rationale:Relapsing polychondritis (RP) is a rare autoimmune-related disease and may be associated with other autoimmune diseases.Patient concerns: Here we reported a case of RP patients with mixed-type AIHA. The patient was diagnosed with RP in March 2008 which was treated and the patient was in stable condition. Laboratory data revealed progressive decrease in hemoglobin during her hospitalization due to pulmonary infection in 2016. Positive Coombs’ test and moderate titer of anti-cold agglutinin was detected.Diagnosis:Mixed-type AIHA was diagnosed as a comorbidity in this case given the circumstance that her RP was stable and low-dose oral corticosteroids was enough to maintain remission.Interventions:The patient was treated with intravenous immunoglobulin and steroids.Outcomes:The patient's body temperature dropped and hemoglobin levels rose in 2 weeks.Lessons:Reports of RP patients with autoimmune hemolytic anemia (AIHA) are extremely rare and cases with the mixed-type AIHA has not been reported. Here we describe a case of RP with mixed-type AIHA which was considered as a comorbidity rather than a complication.

A 79‐Year‐Old Female Patient With Altered Mental Status and Anemia

“…The patient discussed in this article had a unique presentation with the presence of concomitant warm and cold autoantibody–mediated hemolytic anemia, or mixed AIHA. Mixed AIHA has been reported in autoimmune disorders such as SLE (6), Sjögren's syndrome (31), and relapsing polychondritis (32) as well as in AITL (33). The older age of the patient and the presence of cold agglutinins raised our concern for a malignant process over SLE and prompted additional evaluation, including the lymph node biopsy, ultimately revealing the diagnosis.…”