Concepedia

Severe autoimmune hemolytic anemia in a liver transplanted child

Michela Schäppi, Thierry Peyrard, Fabienne Gumy‐Pause, Klara M. Posfay‐Barbe, Christophe Chardot, Dominique C. Belli, Michèle A. Siegenthaler

Pediatric Transplantation · 2008 · 18 citations · 22 references

DOI

TL;DR

AIHA can complicate solid organ and bone marrow transplantation early after transplant. The report describes the first case of mixed warm‑acting IgM and IgG AIHA in a 16‑month‑old boy eight months post‑liver transplant and reviews etiologies and treatment strategies for post‑transplant pediatric hemolytic anemia. The authors reviewed etiologies of hemolytic anemia in post‑transplant pediatric patients and discussed various treatment strategies. The case highlights the complexity of this rare AIHA and demonstrates rituximab efficacy, the need for transfusion support with rare blood, and the importance of international collaboration.

Abstract

AIHA can complicate solid organ and bone marrow transplantation early after transplant. We describe the first case report of a 16-month-old boy with mixed type warm-acting IgM and warm IgG autoantibodies AIHA, occurring eight months after liver transplantation. This case describes the complexity of this very rare form of AIHA. It also illustrates the efficacy of rituximab in this indication, as well as the transfusion support with extremely rare blood, along with the importance of international collaboration to provide it. In this report, the etiologies of HA occurring in post-transplant pediatric patients are reviewed and the different treatment strategies are discussed.