Table I.
Characteristics of seven patients with autoimmune haemolytic anaemia after the onset of COVID‐19.
Patient | Age | Gender | Comorbidity | CT‐scan* | Oropharyngeal swab (tested by PCR) | Haemoglobin (g/l) | Reticulocyte count (109/l) | Lymphocyte count (109/l) | Lactate dehydrogenase (U/l) | Haptoglobin (g/l) | DAT specificity | Optimum temperature | Day between COVID‐19 symptoms and AIHA | Related pathology | AIHA treatment | Response |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
#1 | 61 | M | Hypertension, chronic renal failure | Moderate | Positive | 60 | 477 | 250 | 1000 | <0·1 | IgG + C3d | warm | 13 | CLL | Steroids | Ongoing |
#2 | 89 | F | Hypertension, chronic renal failure, atrial fibrillation | Mild | Positive | 84 | 103 | 1·7 | 598 | <0·1 | IgG + C3d | warm | 7 | MGUS | Steroids | Ongoing |
#3 | 62 | F | Hypertension, cirrhosis | Severe | Positive | 108 | 101 | 1·3 | 357 | <0·1 | C3d | cold | 4 | MZL† |
1. Steroids 2. Rituximab |
PR Planed |
#4 | 69 | F | Obesity | Moderate | Positive | 38 | 215 | 5·9 | 2610 | <0·1 | IgG + C3d | cold | 10 | MZL | Steroids | PR |
#5 | 61 | M | Hypertension, chronic renal failure, diabetes, hypercholesterolaemia | Mild | Positive | 72 | 145 | 3 | 807 | 0·8 | C3d | cold | 11 | Prostate cancer | RBC infusion | Ongoing |
#6 | 61 | M | Diabetes | Severe | Positive | 70 | 155 | 1·2 | 1800 | <0·1 | IgG | warm | 9 | None |
1. Steroids 2. Rituximab‡ |
Failure Ongoing |
#7 | 75 | M | Diabetes, hypercholesterolaemia, cardiopathy, obesity, chronic obstructive bronchopneumopathy | Moderate | Positive | 71 | 98 | 108 | 2000 | <0·1 | IgG | warm | 6 | CLL | RBC infusion | Ongoing |
CT, computed tomography; PCR, polymerase chain reaction; DAT, direct antiglobulin test; AIHA, autoimmune haemolytic anaemia; CLL, chronic lymphocytic leukaemia; MGUS, monoclonal gammopathy of undetermined significance; MZL, marginal zone lymphoma; RBC, red blood cells; PR, partial response.
Degree of involvement of the lung was classified as none (0%), minimal (1–25%), mild (26–50%), moderate (51–75%), or severe (76–100%).
MZL B cell clone was detected in the bone marrow.
Patient 6 received rituximab injection because of corticosteroid failure.