Abstract
We report a rare case of autoimmune hemolytic anemia (AIHA) with reticulocytopenia and erythroblastosis in peripheral blood. A 9-month-old boy was admitted to our hospital because of a pale face and general malasis. Peripheral blood revealed RBC 168×104/μl, Hb 4.7g/dl, reticulocyte 15‰ (25, 100/μl), nucleated RBC (NRBC) 3/200 WBC, WBC 20, 400/μl and T. bilirubin 2.0mg/dl. Both direct and indirect Coombs tests were positive and anti-e antibody was identified. The patient was diagnosed as having AIHA and treated with prednisolone (2mg/kg/day) and gammaglobulin (400mg/kg/day for 5 consecutive days), but hemolysis with reticulocytopenia and erythroblastosis in the peripheral blood continued in spite of the therapy. These findings suggest that not only mature RBC but also reticulocytes were destroyed. Pulse therapy with methylprednisolone was employed and a dramatic improvement of hemolysis was noted. The boy was in complete remission for two years after onset.
