Case 50 part 1 – update

We were reviewing the marrow smear from an elderly gentleman with weight loss and macrocytic anaemia. Further results include:

  • Reticulocyte count 276×10*9/L
  • Bilirubin 54ug/L
  • LDH 1056U/L
  • DAT IgG 4+


The above is consistent with warm autoimmune haemolytic anemia. The bone marrow showed these features:


This is consistent with erythrophagocytosis, which can be seen in haemolytic anaemia.



  • What are the causes of warm haemolytic anaemia?
  • Any further investigations on the patient’s bone marrow?
  • Any further investigations in the peripheral blood?
  • What would be first line treatment for warm AIHA?


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