Open AccessA254 IGA-MEDIATED WARM AUTOIMMUNE HEMOLYTIC ANEMIA IN A PATIENT WITH CROHN’S DISEASE ON VEDOLIZUMAB
Author(s) -
Matthew Cheah,
Reena Khanna
Publication year - 2020
Publication title -
journal of the canadian association of gastroenterology
Language(s) - English
Resource type - Journals
eISSN - 2515-2092
pISSN - 2515-2084
DOI - 10.1093/jcag/gwz047.253
Subject(s) - vedolizumab , medicine , autoimmune hemolytic anemia , anemia , crohn's disease , rituximab , iron deficiency anemia , gastroenterology , autoimmune gastritis , inflammatory bowel disease , hemolytic anemia , immunology , disease , antibody , autoimmunity
Background Iron deficiency anemia and anemia of chronic disease are relatively common manifestations of Crohn’s disease. Autoimmune hemolytic anemia, however, is quite rare with few reported cases. Aims To present a rare case of IgA-mediated warm autoimmune hemolytic anemia in Crohn’s Disease. Methods A chart review and literature search were performed in preparation of this case report. Results A 21-year-old male with a recent diagnosis of Crohn’s disease on Vedolizumab presents to infusion clinic with generalized weakness, coke-colored urine and weight loss. Physical examination was remarkable for tachycardia and jaundice. Laboratory investigations revealed profound anemia with IgA-mediated DAT positivity. The patient remained admitted in hospital for a prolonged period. Bone marrow biopsy, CT imaging and infectious workup were negative. Vedolizumab was held and treatment with both high-dose corticosteroids and rituximab was required. Eventually, the anemia would stabilize and Vedolizumab was safely resumed as an outpatient. Conclusions Here we report a both rare and challenging case of IgA-mediated DAT positive autoimmune hemolytic anemia in a patient with Crohn’s disease who was successfully treated with corticosteroids and rituxumab. Funding Agencies None