Tuberculosis induced autoimmune haemolytic anaemia: a systematic review to find out common clinical presentations, investigation findings and the treatment options

Rathish, Devarajan; Siribaddana, Sisira

doi:10.1186/s13223-018-0236-y

Cited by 12 publications

(6 citation statements)

References 31 publications

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“…Although the host increased RBC production, anemia established because of decreased erythrocyte life span and increased erythrocyte degradation, suggesting that features of hemolytic anemia account for the establishment of anemia in disseminated mycobacterial infections. The occurrence of hemolytic anemia in TB patients has been occasionally reported, especially during disseminated TB (51)(52)(53). More cases may have been overlooked because relevant hematological parameters needed to discriminate between different types of anemia are not usually included in routine assessments.…”

Section: Discussionmentioning

confidence: 99%

IFN-γ–Dependent Reduction of Erythrocyte Life Span Leads to Anemia during Mycobacterial Infection

Gomes

Moreira

Silva

et al. 2019

The Journal of Immunology

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Anemia is a frequent and challenging complication of mycobacterial infections. We used a model of disseminated Mycobacterium avium infection in mice to investigate the mechanisms of mycobacteria-induced anemia. We found increased formation of RBC in the bone marrow and spleen of infected mice. Infection induced reticulocytosis and the premature egress of immature progenitors to the systemic circulation in an IFN-g (IFNG)-dependent way. The newly formed RBC had reduced CD47 surface expression and a reduced life span and were phagocytosed in the liver of infected mice, increasing iron recycling in this organ. The increased engulfment and degradation of RBC was independent of IFNG sensing by macrophages. Together, our findings demonstrate that mycobacterial infection alters the formation of erythrocytes, leading to their accelerated removal from circulation and hemolytic anemia. This comprehensive elucidation of the mechanisms underlying mycobacteria-induced anemia has important implications for its efficient clinical management.

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Section: Discussionmentioning

confidence: 99%

IFN-γ–Dependent Reduction of Erythrocyte Life Span Leads to Anemia during Mycobacterial Infection

Gomes

Moreira

Silva

et al. 2019

The Journal of Immunology

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“…AIHA has been reported in cases of tuberculosis. 23 Five patients with HIV positivity were shown to have positive DAT, and the association has been described in studies. 24,25 Hemolysis seen in the remaining one case was due to plasmodium falciparum malaria.…”

Section: Discussionmentioning

confidence: 92%

Untitled

2022

J Lab Physicians

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Objectives Detection of red cell bound immunoglobulins and/or complement by direct antiglobulin test (DAT) is a crucial serological assay in the diagnosis of autoimmune hemolytic anemia (AIHA). However, DAT may be positive in a variety of clinical conditions with or without hemolysis. We aimed at evaluating the clinical and serological correlation of positive DAT by categorizing the clinical conditions associated with positive DAT, estimating the presence of in vivo hemolysis in case of positive DAT with polyspecific and monospecific antisera and correlating the strength of positive DAT with the presence of hemolysis. Materials and MethodsThe prospective observational study was performed on 200 samples that were positive for DAT with polyspecific antiglobulin reagent as the baseline investigation. These samples were further tested with anti-immunoglobulin G and anti-C3 monospecific DAT reagents to evaluate the type of protein responsible for positive DAT. The antiglobulin tests were performed by tube technique. DAT positivity was graded (1þ to 4 þ ) in each patient. Autocontrol test was included. The patients with positive polyspecific DAT were categorized into different clinical conditions. The presence or absence of in vivo hemolysis was evaluated in all clinical categories and also for each grade of positivity with polyspecific and monospecific antiglobulin reagents. Statistical Analysis Binomial logistic regression and Mann-Whitney U test were applied to between the group analyses. For categorical variables, Fisher's exact test and relative risk were used. The qualitative data were expressed in numbers and percentages. Results The highest number of patients (75/200, 37.5%) belonged to the autoimmune diseases group. Tuberculosis and hepatitis C were the main infectious diseases associated with positive DAT. Out of 200 DAT-positive patients, 98 (49%) had in vivo hemolysis and 102 (51%) did not have hemolysis. AIHA ( 22) and systemic lupus erythematosus (18) were the commonest clinical conditions associated with in vivo hemolysis. All the 11 samples that showed positivity with only anti-C3 reagent did not show any hemolysis. There was statistically significant increase in the incidence of in vivo hemolysis with increasing grades of DAT positivity with all the three antihuman globulin reagents. Conclusion There are different disease conditions which show positive DATwith or without hemolysis. So, it is important to clinically and serologically correlate positive DAT results.

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“…50 years of age. 11 The pulmonary tract is infused with chronic infections and adverse responsive mechanisms of action delivered by the macrophages. Apart from the pulmonary destructions, TB can damage the cardiovascular system and nervous system and cause many blood-related disorders, including anemia, thrombocytopenia, basophilia, leukocytosis, and many other diseases that can potently affect the RBCs shapes, production, and effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Tuberculosis-Induced Autoimmune Hemolytic Anemia

Alebbi

Kambal

Samra

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Tuberculosis (TB) is an infectious disease that affects different organs, causing multiple complications, including hematological sequelae. One of the most common TB-hematological complications is anemia of chronic disease. Very rarely autoimmune hemolytic anemia (AIHA) has been reported as an uncommon manifestation of TB. In this case, we present a female who presented with refractory AIHA, which was attributed to disseminated TB. The patient responded well to steroids, anti-TB medications, and rituximab.

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Tuberculosis induced autoimmune haemolytic anaemia: a systematic review to find out common clinical presentations, investigation findings and the treatment options

Cited by 12 publications

References 31 publications

IFN-γ–Dependent Reduction of Erythrocyte Life Span Leads to Anemia during Mycobacterial Infection

IFN-γ–Dependent Reduction of Erythrocyte Life Span Leads to Anemia during Mycobacterial Infection

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Case Report: Tuberculosis-Induced Autoimmune Hemolytic Anemia

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