Reply to M-L Puhlmann and WM de Vos

Araj‐Khodaei, Mostafa; Ghazi-Sha’rbaf, Javad; Taheri-Targhi, Somaiyeh; Mohammadinasab, Reza

doi:10.1093/advances/nmaa065

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(1 citation statement)

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“…We should perform a hemolytic panel, including reticulocyte counts, lactate dehydrogenase, haptoglobin, direct Coombs test, and cold agglutinins in these patients. [ 20 ] We should initiate plasma exchange immediately in patients with severe cold agglutinemia to remove cold agglutinin. [ 21 ] We should rule out other causes of anemia, such as cobalamin and folate deficiencies; renal, hepatic, or thyroid dysfunction; nonautoimmune hemolysis (for example, hemoglobinopathies); or other primary bone marrow disorders.…”

Section: Discussionmentioning

confidence: 99%

Anemia ‐ an initial manifestation of Bing‐Neel syndrome: A case report

Yang

Chong

et al. 2022

Medicine

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Rationale: It is very likely that we will miss Bing-Neel syndrome (BNS) when its initial sign is anemia. Patient concerns: A 59-year-old woman presented with episodic loss of consciousness, anemia, and extremity muscle strength scores (5-) and extremity tendon reflexes (++).Diagnoses: Magnetic Resonance Imaging (MRI) showed abnormal signal in the left hippocampus, left insula, and right occipital lobe. Quantitative serum immunoglobulins showed elevated immunoglobulinm (IgM) (60.6g/L). Bone marrow biopsy showed lymphoplasmacytic lymphoma (LPL) and tested positive for the MYD88 L265P mutation suggesting Waldenström macroglobulinemia (WM).Interventions: The patient underwent 3 plasma exchange treatments in the department of hematology followed by chemotherapy (cyclophosphamide for injection, bortezomib for injection).

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Section: Discussionmentioning

confidence: 99%