Abstract
BACKGROUND: Iron deficiency anemia and anemia of chronic disease are relatively common manifestations of Crohn’s disease. Autoimmune hemolytic anemia, however, is quite rare with few reported cases. AIMS: To present a rare case of IgA-mediated warm autoimmune hemolytic anemia in Crohn’s Disease. METHODS: A chart review and literature search were performed in preparation of this case report. RESULTS: A 21-year-old male with a recent diagnosis of Crohn’s disease on Vedolizumab presents to infusion clinic with generalized weakness, coke-colored urine and weight loss. Physical examination was remarkable for tachycardia and jaundice. Laboratory investigations revealed profound anemia with IgA-mediated DAT positivity. The patient remained admitted in hospital for a prolonged period. Bone marrow biopsy, CT imaging and infectious workup were negative. Vedolizumab was held and treatment with both high-dose corticosteroids and rituximab was required. Eventually, the anemia would stabilize and Vedolizumab was safely resumed as an outpatient. CONCLUSIONS: Here we report a both rare and challenging case of IgA-mediated DAT positive autoimmune hemolytic anemia in a patient with Crohn’s disease who was successfully treated with corticosteroids and rituxumab. FUNDING AGENCIES: None