[83-year-old with angina pectoris, hemoglobinuria and icterus]

Area of Science:

• Hematology
• Infectious Diseases
• Internal Medicine

Background:

• Autoimmune hemolytic anemia (AIHA) with cold antibodies can present with non-specific symptoms like jaundice and hemolysis.
• Laboratory diagnostics can be challenging due to pre-analytical variables such as sample hemolysis.

Purpose of the Study:

• To report a case of AIHA secondary to Proteus mirabilis bacteremia.
• To emphasize the diagnostic challenges and management strategies for AIHA.

Main Methods:

• Clinical presentation review, laboratory diagnostics including Coombs test and C3d-loaded erythrocyte detection.
• Management involved treating underlying bacteremia with antibiotics and high-dose prednisolone for AIHA.

Main Results:

• The patient presented with angina, hemoglobinuria, and jaundice, complicated by hemolysis and acute kidney injury.
• Diagnosis of cold antibody AIHA was confirmed, with Proteus mirabilis bacteremia identified as the cause.
• Treatment led to regression of hemolysis and patient discharge for follow-up.

Conclusions:

• Proteus mirabilis bacteremia can precipitate AIHA.
• Interdisciplinary collaboration is vital for diagnosing and managing AIHA.
• Blood transfusions in AIHA require strict indications due to potential complications.