Researchers presented the case report of a patient who was diagnosed with autoimmune hemolytic anemia and sarcoidosis in Authorea.
The healthcare providers in the case worked to determine whether the patient’s autoimmune hemolytic anemia could have been driven by cold agglutinins, such as in the case of cold agglutinin disease (CAD).
Sarcoidosis is often accompanied by hematological involvement; patients typically present with lymphopenia and splenomegaly. However, the medical literature is largely silent about any association between autoimmune hemolytic anemia and sarcoidosis.
Tounsi and colleagues described the case of a 40-year-old woman who was admitted for normocytic and regenerative anemia. She was diagnosed with autoimmune hemolytic anemia as her Coombs test was positive for anti-immunoglobulin G.
Read more about CAD etiology
A computed tomography scan was carried out and revealed multiple lymphadenopathy in the mediastinal and abdominal regions, as well as bilateral interstitial lung disease. The patient’s physicians carried out further investigations into possible infectious diseases, malignancies, or other autoimmune diseases; none of these comorbidities were present.
However, a labial biopsy revealed the presence of a noncaseating granuloma; this led to the diagnosis of sarcoidosis. Her physicians prescribed her oral corticosteroids, which were sufficient to achieve remission in both disorders (autoimmune hemolytic anemia and sarcoidosis).
Sarcoidosis is usually diagnosed based on clinical and radiological evidence in the absence of an alternative disease. In this case, the discovery of a noncaseating granuloma was sufficient to point to a diagnosis of sarcoidosis. The exact causes of sarcoidosis remain elusive.
Read more about CAD treatment
The authors of this report could not conclusively determine whether there was a link between the patient’s diagnosis of autoimmune hemolytic anemia and sarcoidosis. Although it is likely that the simultaneous occurrence of both conditions is a coincidence, it is also likely that there may be a pathogenic link that is yet to be elucidated.
While the first-line treatment for autoimmune hemolytic anemia is corticosteroid therapy, the treatment for sarcoidosis depends largely on the patient’s clinical presentation. In the case of the patient in this report, oral steroids were sufficient to achieve remission in both disorders.
Haifa T, Wafa S, Imen C, et al. Autoimmune hemolytic anemia revealing a case of sarcoidosis. Authorea. Published online March 1, 2023. doi:10.22541/au.167767795.57805072/v1