Successful treatment of autoimmune hemolytic anemia by plasma exchange therapy

Abstract

The standard therapy of autoimmune hemolytic anemia is by steroid administration, and blood transfusion is generally avoided but may be administered in cases of life-threatening anemia. We report here a case of severe autoimmune hemolytic anemia that was refractory to steroids and even blood transfusion but recovered by plasma exchange. In this case, we performed plasma exchange to eliminate autoimmune antibodies. After plasma exchange resulted in a rapid and good therapeutic response, we administered rituximab to suppress CD20-positive B cells and maintain the response. Although there is no established evidence yet for the effectiveness of plasma exchange, it seemed to be a good therapeutic option to obtain a rapid and successful effect against severe refractory hemolytic anemia as in our patient.