A Case of Immune-Mediated Coombs-Negative Hemolytic Anemia in a Patient with Systemic Lupus Erythematosus

Abstract

W.M.D.A.S.Wanninayake, Tilan Aponso, Manohari Seneviratne, and Dhanapala Dissanayake

Systemic lupus erythematosus (SLE) is an auto-immune connective tissue disorder that can involve any organ in the body. The American College of Rheumatology criteria (ACR) include autoimmune hemolytic anemia with reticulocytosis as one of the criteria in the diagnosis of SLE. Anti-erythrocyte antibodies in SLE are mainly warm-type IgG. We present a case of systemic lupus erythematosus presenting with immune-mediated Coombs-negative hemolytic anemia. This case highlights the possibility of autoimmune hemolysis occurring with a negative Coombs test, where the autoantibody levels are too low to be detected by a conventional direct antiglobulin test. (DAT)

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