Immune-Mediated Coombs Negative Intravascular Hemolysis in Systemic Lupus Erythematosus
August 2021
in “
BMJ Case Reports
”
TLDR A woman with lupus had blood cell destruction, treated successfully with medication.
A 27-year-old woman with systemic lupus erythematosus (SLE) presented with symptoms including excessive hair loss, weight loss, amenorrhoea, and loss of axillary and pubic hair, followed by fever, vomiting, and abdominal pain. She developed intravascular haemolysis, indicated by a drop in haemoglobin, indirect hyperbilirubinaemia, raised LDH, and haemoglobinuria. Despite a negative Coombs test, she tested positive for antinuclear antibody, anti-dsDNA, anti-Sm, and anti-SS-A/Ro antibodies, with low complement C3. Diagnosed with SLE and immune-mediated intravascular haemolysis, she was treated with prednisolone and hydroxychloroquine, which resolved the haemolysis, and no further episodes occurred during follow-up.
