Primary biliary cirrhosis and cold autoimmune hemolytic anemia: effect of partial plasma exchange

The previously unreported occurrence of primary biliary cirrhosis with cold autoimmune hemolytic anemia is described. Red cell survival studies showed a t1/2 of 11.1 days. Partial plasma exchange increased red cell survival to 15.8 days. Concomitantly, alkaline phosphatase, SGOT, SGPT, and bilirubin was reduced in predictable amounts but rebounded to prepheresis levels quickly. Although partial plasma exchange was effective in increasing red cell survival and in reducing the level of selected abnormal plasma components, the patient died 3 mo after initiation of plasma exchange therapy. Partial plasma exchnage did not appear to have any long-term beneficial effects on either liver disease or the hemolytic process.