Autoimmune Hemolytic Anemia following Septic Shock with Escherichia Coli; a Case Report

Sepsis is a severe, life-threatening illness caused when the immune system responds inappropriately to infections, causing organ deterioration and negatively affecting the systems inside the body, one of which is the coagulation system. Most hematologic changes in red blood cells (RBCs) are non-antibody-mediated hemolytic anemia (NAHA). Autoimmune hemolytic anemia (AIHA) is a rare condition, challenging in diagnosis, requiring prompt recognition and management. Warm hemolytic anemia has recently been reported in patients with septic shock. This report presents a sepsis-induced autoimmune hemolytic anemia case. A 44-year-old Vietnamese female with no chronic disease came to the emergency department because of sudden periumbilical colicky pain after consuming a fresh garden salad. The abdominal pain appeared nine hours after the meal, following vomiting. Twelve hours later, she developed diarrhea, subsequently a fever, and chills. She was admitted to the emergency department in the fifteenth hour of the first symptom. Septic shock, multiple organ failure, and warm autoimmune hemolysis were all present in the patient. Hemolytic anemia and multiorgan failure made the situation worse, leading to death. Autoimmunity hemolytic anemia in sepsis or septic shock is rare, but treating both emergency hemolytic anemia and potential infectious etiology is crucial in acute situations.