A CASE REPORT ON AUTOIMMUNE HEMOLYTIC ANEMIA WITH BICYTOPENIA
Autoimmune hemolytic anemia (AIHA)is the rare autoimmune disorder results in the production of the antibodies against the red blood cell causing shortened erythrocyte survival4. The estimated incidence of AIHA is of 1 to 3 cases in 1,00,000 persons per year.4 The identification and classification of AIHA cases can be done carefully. The most confirmatory test of AIHA is positive Direct Antiglobulin Test (DAT). The treatment option of AIHA is still unclear. Corticosteroids is the first line treatment for AIHA and Rituximab is the second line treatment option for AIHA patients1. Splenectomy is the procedure done for refractory or relapsed case patients and only 20 % of the patients is cured1. Bicytopenia is the rare condition occurred in the patients where the restriction of two lines (RBC, WBC and platelet) 4. The treatment option for bicytopenia is not still evidence based. Bone marrow aspiration is performed for malignancy or non-malignancy, in case of severe anemia blood transfusion is performed and also treated with multivitamins4.Early diagnosis of AIHA with bicytopenia can be done through routine supervision of Complete Blood Count of anemia patients and anemia patients who underwent blood transfusion during previous years help to identify the prediction of autoimmune disorders1.A 22 year old female patient was admitted in the hospital with chief complaints of severe anemia , fatigue , knee pain and loose stools. Due to her low hemoglobin level (3.9 mg/dl) at the age of 14, she had Previously undergone blood transfusions. On examination, she had mild splenomegaly, Pallor ++. Routine monitoring of the hemoglobin, total WBC count, ESR, and platelet count was carried out during hospitalization. A bone marrow aspiration was performed to look for malignancy, but the results were negative. Bicytopenia was identified after a peripheral smear test on RBC, WBC, and platelets revealed, reduced RBC and WBC1.We report here a case of AIHA in a patient with bicytopenia which was detected in our blood disorder centre