Abstract AUTOIMMUNE hemolytic anemia is not uncommonly associated with malignant reticuloendothelial disease. It has been frequently described in association with the chronic leukemias but rarely occurs in the acute types, and only one patient has been reported to have a concomitant carcinoma.1 Dausset and Colombani2 studied 128 patients with autoimmune hemolytic anemia; none had an underlying carcinoma or acute leukemia. We wish to present an unusual patient with polycythemia vera who was treated with sodium phosphate P 32 and developed acute myelogenous leukemia and adenocarcinoma of the lung complicated by an autoimmune hemolytic anemia. Report of a Case A 62-year-old white woman (04-92-98), entered the National Institutes of Health Clinical Center for the first time in May 1963, with a four-month history of night sweats, occipital headaches, and intense pruritis after bathing. Physical examination revealed a ruddy cyanosis; a blood pressure of 165/95 mm Hg; pulse rate, 100 References 1. Dacie, J.V.: "The Hemolytic Anaemias, Congenital and Acquired," part 2 , in The Autoimmune Hemolytic Anaemias , Grune & Stratton, Inc, 1962, p 343. 2. Dausset, J., and Colombani, J.: The Serology and the Prognosis of 128 Cases of Autoimmune Hemolytic Anemia , Blood 14:1280-1301, 1959. 3. Barker, W.H.: Excretion of Bile Pigments and Hepatic Function in Diseases of Blood , Arch Intern Med 62:222-246, 1938.Crossref 4. Block, M.; Jacobson, L.O.; and Bethard, W.F.: Preleukemic Acute Human Leukemia , JAMA 152: 1018-1028, 1953.Crossref 5. Meacham, G.C., and Weisberger, A.S.: Early Atypical Manifestations of Leukemia , Ann Intern Med 41:780-797, 1954.Crossref 6. Brody, J.I., and Finch, S.: Serum Factors of Acquired Hemolytic Anemia in Leukemia and Lymphoma , J Clin Invest 40:181-187, 1961.Crossref 7. Ben-Ishoy, D.; Freund, M.; and Groen, J.J.: A Case of Autoimmune Hemolytic Anemia With Circulating Cold Agglutinins Presenting for Many Years as "Hypersplenism" and Terminating in Leukemia , Blood 22:100-108, 1963. 8. Eng, L.L., and Sinnadurai, C.: Syndrome of Erythemia di Guglielmo After Lightning Injury With Autoimmune Antibodies and Terminating in Acute Monocytic Leukemia , Blood 25:845-849, 1965. 9. Valeri, M.O.; Di Piero, G.; and Carapella, E.: Considerazioni su 11 casi di Anemia Emulitica Autoimmune in eta Pediatrica , Riv Ist Sieroter Ital 39:215-217, 1964. 10. Parof, A., and Dausset, J.: Les Icterus Hemolytiques au Cours des Affections Malignes , Sem Hop Paris 28:290-307, 1952. 11. Frumin, A.M., and Kohn, A.: Autoimmune Hemolytic Disease in Acute Leukemia , Arch Intern Med 9:326-327, 1955.Crossref 12. Fudenberg, H.H.: Heterologous and Homologous Anti-γ-globulins, read before the eighth annual meeting of the American Society of Hematologists, 1965. 13. Wiener, A.S., et al: Type Specific Cold Autoantibodies as a Cause of Acquired Hemolytic Anemia and Hemolytic Transfusion Reactions: Biologic Test With Bovine Red Cells , Ann Intern Med 44:221-240, 1956.Crossref 14. Rose, B.: " The Cryopathies ," in Samter, M. (ed.): Immunological Diseases , Boston: Little, Brown & Company, 1965, p 717.
Archives of Internal Medicine – American Medical Association
Published: Sep 1, 1967