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.
Questions:
- 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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