Rituximab therapy for cytomegalovirus-associated auto-immune hemolytic anemia in a liver-transplant recipient

Autoimmune hemolytic anemia in pediatric liver or combined liver and small bowel transplant patients: a case series and review of the literature

“…Interestingly, many of the patients in the previously reported cases were diagnosed with CAS (7/17 patients) 9‐11,13,15 . This is different from our experience since all six of our patients developed WAIHA, including two with concomitant cold agglutinins, and none developed CAS alone.…”

“…We identified eight published reports of AIHA occurring in the setting of liver or small bowel transplantation (see Tables 3 and 4). [8][9][10][11][12][13][14][15] In all, 17 patients were diagnosed and treated for AIHA, 13 of whom were pediatric patients and four were adults. Of the 17 reported patients, one died before initiation of treatment and one was treated with steroids only.…”

“…[4][5][6][7] Until recently, there had been only a handful of reports in the literature of AIHA in the setting of solid organ transplantation and none of these publications were sufficiently powered to report the incidence. [8][9][10][11][12][13][14] However, the retrospective study published in 2009 by Botija and coworkers 15 found that AIHA occurred at an incidence of 12.2% in 49 pediatric intestinal transplant patients. Surprisingly, CAS appeared to be the most common type of AIHA, followed by WAIHA and mixed AIHA in all of these reported cases.…”

Severe Anemia, Gastric Ulcer, Pneumonitis and Cholangitis in a Liver Transplant Patient: Multiple Organic Dysfunction and One Etiology: A Case Report

“…Severe nonimmune hemolytic anemia, with gastric, pulmonary, and probably choledochal involvement, is exceptional. The pathophysiology of CMV-associated hemolytic anemia (immune and nonimmune) remains unclear [2,3]. In case of autoimmune hemolytic anemia, CMV infection might result in autoreactive B-lymphocyte clones.…”

Refractory immune hemolytic anemia in an immunocompetent infant with cytomegalovirus infection

“…Severe CMV‐associated hemolysis has been described mostly in immunocompromised patients, but it can occur in immunocompetent hosts as well . Reported cases were managed with corticosteroids, IVIG, and sometimes rituximab in both immunosuppressed and immunocompetent settings . CMV antiviral treatment is mandatory in immunocompromised children since it reduces mortality; the same remains to be proven in immunocompetent infants.…”