Direct antiglobulin test-negative autoimmune hemolytic anemia in a patient with β-thalassemia minor during pregnancy: A case report

Abstract

BACKGROUND

Severe refractory anemia during pregnancy can cause serious maternal and fetal complications. If the cause cannot be identified in time and accurately, blind symptomatic support treatment may cause serious economic burden. Thalassemia minor pregnancy is commonly considered uneventful, and the condition of anemia rarely progresses during pregnancy. Autoimmune hemolytic anemia (AIHA) is rare during pregnancy with no exact incidence available.

CASE SUMMARY

We report the case of a 30-year-old β-thalassemia minor multiparous patient experiencing severe refractory anemia throughout pregnancy. We monitored the patient closely, carried out a full differential diagnosis, made a diagnosis of direct antiglobulin test-negative AIHA, and treated her with prednisone and intravenous immunoglobulin. The patient gave birth to a healthy full-term baby.

CONCLUSION

Coombs-negative AIHA should be suspected in cases of severe hemolytic anemia in pregnant patients with and without other hematological diseases.

Keywords: Maternal anemia; β-thalassemia minor; Autoimmune hemolytic anemia; Direct antiglobulin test; Pregnancy; Case report

Core Tip: Severe maternal anemia can cause serious adverse effects with a significant increase in maternal and neonatal mortality. We report the successful diagnosis and treatment of direct antiglobulin test test-negative autoimmune hemolytic anemia in a patient with β-thalassemia minor during pregnancy. The findings from this case report suggest that maternal anemia can have multiple etiologies, and blood transfusion is not always the appropriate treatment.