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Updated: Oct 23, 2025
05:23
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
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Hemolytic anemia and plasma exchange
Istemi Serin1, Mehmet Hilmi Dogu2
1University of Health Science, Istanbul Training and Research Hospital, Department of Hematology, Istanbul, Turkey.
Summary
Plasma exchange (PE) offers a vital treatment option for severe autoimmune hemolytic anemia unresponsive to standard therapies. This case report highlights PE
Area of Science:
- Hematology
- Immunology
- Internal Medicine
Background:
- Autoimmune hemolytic anemia (AIHA) results from autoantibodies, often idiopathic.
- Corticosteroids are first-line, with other immunosuppressives and IVIG for refractory cases.
- Plasma exchange (PE) removes autoantibodies and immune complexes, aiming for rapid response.
Observation:
- A patient with severe IgG subtype AIHA showed no response to methylprednisolone, rituximab, and IVIG.
- Five sessions of PE were administered every other day due to unresponsiveness to immunosuppressive therapies.
- Following PE, transfusion requirements decreased, and the patient proceeded to splenectomy.
Findings:
- PE was effective in reducing transfusion needs for a patient with refractory AIHA.
- This intervention served as a crucial bridge to definitive treatment, such as splenectomy.
- The patient is now managed with oral cyclosporine, maintaining a hemoglobin level of 14.7 g/dL.
Implications:
- Plasma exchange can be a valuable third-line option for severe, refractory AIHA, particularly in cases with cardiovascular instability.
- PE may facilitate faster patient stabilization and serve as a bridge to splenectomy.
- This approach expands therapeutic options for complex autoimmune hemolytic anemia cases.
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