Coombs-positive autoimmune hemolytic anemia in Crohn??s disease

Plikat, Katharina; Rogler, Gerhard; Schölmerich, Jürgen

doi:10.1097/00042737-200506000-00011

Cited by 13 publications

(14 citation statements)

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“…AIHA is highly associated (9.7% of cases) with the antiphospholipid antibody syndrome [37]. The prevalence of AIHA is particularly high in patients with SLE who also have antiphospholipid antibodies [38] There is a definitive association between WA-AIHA and ulcerative colitis [65,66], and a less well established association between AIHA and Crohn's disease [67]. Patients with ulcerative colitis and AIHA show a male preponderance and have a more severe disease course [65].…”

Section: Wa-aiha Associated With Collagen Disordersmentioning

confidence: 99%

Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review

Valent

Lechner

2008

Wien Klin Wochenschr

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Autoimmune haemolytic anaemia (AIHA) is an immune disorder caused by antibodies directed against unmodified autologous red cells. The disorder may be a primary (idiopathic) or a secondary disease. The diagnosis is based on the presence of anaemia, signs of haemolysis with reticulocytosis, low haptoglobin, increased lactate dehydrogenase, elevated indirect bilirubin, and a positive direct antiglobulin test (Coombs test). Sometimes, not all of these typical features are present. Most AIHA are caused by warm antibodies, whereas cold antibodies are less commonly detected. While half of the warm antibody-based AIHA are idiopathic anaemias, almost all cold antibody AIHA are secondary anaemias. Underlying diseases are Non Hodgkin's lymphomas and systemic autoimmune disorders, and less frequently organ transplantation, infections, or solid tumors. Moreover, AIHA is an important complication of treatment with nucleoside analogs. Most patients with AIHA require therapy. In warm antibody AIHA, standard first line therapy are glucocorticosteroids with or without high dose immunoglobulins, whereas splenectomy is considered second-line therapy. Response rates of primary AIHA to corticosteroid therapy are high. After initial remission, the dose should be tapered down slowly and with caution, and in some cases, low-dose maintenance therapy is required. The efficacy of standard therapy is low in secondary AIHA that develops in lymphoma patients, posttransplant patients, or tumor patients. Among other immunosuppressive treatments, rituximab (anti-CD20) appears to be highly effective in patients with warm antibody AIHA refractory to standard therapy. Mycophenolate mofetil is quite effective in AIHA patients with an underlying autoimmune or lymphoproliferative disease. Patients with cold agglutinins are refractory to steroids and splenectomy. Half of these patients may respond to rituximab, although responses usually are short-lived. Sometimes, AIHA that is associated with malignant lymphomas or tumors, disappears after successful anti-lymphoma or anti-tumor therapy.

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Section: Wa-aiha Associated With Collagen Disordersmentioning

confidence: 99%

Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review

Valent

Lechner

2008

Wien Klin Wochenschr

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“…In our patient AIHA can be attributed to an immunologic dysregulation due to an otherwise quiescent CD. 2 The thrombosis of the ophthalmic artery, on the other hand, seems to be related to the recorded AT III deficiency. Gastrointestinal protein leaking, due to mucosal injury, 6 consumption, or inactivation of AT III 7 and downregulation of AT III-due to reprioritization of liver protein synthesis 8 could explain this deficiency.…”

Section: To the Editormentioning

confidence: 99%

“…Autoimmune hemolytic anemia (AIHA) and thromboembolic events occurring before, during, or after the diagnosis of IBD are included in this extraintestinal repertoire. [1][2][3] In the case described below both the AIHA and the thromboembolic event preceded the intestinal manifestations of Crohn's disease (CD).…”

Section: To the Editormentioning

confidence: 99%

“…2 The most popular hypothesis with regard to the pathogenesis of AIHA in IBD is that the absorption of non-red cell antigens through the diseased bowel causes the development of antibodies with cross-reactivity to the patient's red cells. 3 Thrombosis, on the other hand, occurs in 2%-10% of IBD patients and can be due to thrombocytosis, activation of coagulation cascade, reduction of antithrombotic agents, or genetic predisposition.…”

Section: To the Editormentioning

confidence: 99%

“…1 Both the AIHA and thrombosis may precede, accompany, or follow the onset of IBD. [1][2][3] To our knowledge only 1 case of AIHA before CD diagnosis 4 and a single case of ophthalmic artery thrombosis before the onset of CD 5 have been reported. However, a case including the onset of both manifestations, AIHA and thrombosis of the ophthalmic artery, before evident CD, has never been published.…”

Section: To the Editormentioning

confidence: 99%

See 2 more Smart Citations

Autoimmune hemolytic anemia and ophthalmic artery thrombosis preceding the intestinal manifestations of Crohnʼs disease

Tsiopoulos

Manolakis

Kapsoritakis

et al. 2009

Inflammatory Bowel Diseases

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Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

et al. 2019

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Fatigue is a burdensome, multidimensional, and multifactorial symptom that is associated with a wide array of chronic illnesses, specifically occurring in nearly 50% of patients with inflammatory bowel disease (IBD). Although common, given its subjective nature, physicians often under-recognize and undertreat this debilitating symptom. There are multiple etiologies that can contribute to fatigue in patients with IBD, including disease activity, anemia, medications, psychosomatic symptoms, and alterations to the gut-brain axis. The management of fatigue in IBD can be challenging, as it is often times multifaceted. In this review, we summarize the available tools for the diagnosis and measurement of fatigue, discuss etiologies, and make recommendations for their management. We identify knowledge gaps for the workup and treatment of fatigue and propose an algorithm to aid physicians in the evaluation and management of fatigue in this unique population. However, future research is needed to address several areas of knowledge deficits and improve the management of fatigue in IBD.

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Coombs-positive autoimmune hemolytic anemia in Crohn??s disease

Cited by 13 publications

References 14 publications

Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review

Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review

Autoimmune hemolytic anemia and ophthalmic artery thrombosis preceding the intestinal manifestations of Crohnʼs disease

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

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