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Scientific paper - Case study
Combined megaloblastic and immunohemolytic anemia associated - case report
Acta clinica Croatica, 47 (2008), 4; 239-243. urn:nbn:hr:220:047445
Vucelić, Vesna; Stančić, Vladimir; Ledinsky, Mario; Getaldić, Biserka; Sović, Dragica; Dodig, Javorka; Grbac, Ljiljana; Gaćina, Petar; Rinčić, Goran; Čaržavec, Dubravka

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Vucelić, V., Stančić, V., Ledinsky, M., Getaldić, B., Sović, D., Dodig, J. ... Čaržavec, D. (2008). Combined megaloblastic and immunohemolytic anemia associated - case report. Acta clinica Croatica, 47. (4), 239-243. Retrieved from https://urn.nsk.hr/urn:nbn:hr:220:047445

Vucelić, Vesna, et al. "Combined megaloblastic and immunohemolytic anemia associated - case report." Acta clinica Croatica, vol. 47, no. 4, 2008, pp. 239-243. https://urn.nsk.hr/urn:nbn:hr:220:047445

Vucelić, Vesna, Vladimir Stančić, Mario Ledinsky, Biserka Getaldić, Dragica Sović, Javorka Dodig, Ljiljana Grbac, Petar Gaćina, Goran Rinčić and Dubravka Čaržavec. "Combined megaloblastic and immunohemolytic anemia associated - case report." Acta clinica Croatica 47, no. 4 (2008): 239-243. https://urn.nsk.hr/urn:nbn:hr:220:047445

Vucelić, V., et al. (2008) 'Combined megaloblastic and immunohemolytic anemia associated - case report', Acta clinica Croatica, 47(4), pp. 239-243. Available at: https://urn.nsk.hr/urn:nbn:hr:220:047445 (Accessed 04 May 2024)

Vucelić V, Stančić V, Ledinsky M, Getaldić B, Sović D, Dodig J, and sur.. Combined megaloblastic and immunohemolytic anemia associated - case report. Acta clinica Croatica [Internet]. 2008 [cited 2024 May 04];47(4):239-243. Available at: https://urn.nsk.hr/urn:nbn:hr:220:047445

V. Vucelić, et al., "Combined megaloblastic and immunohemolytic anemia associated - case report", Acta clinica Croatica, vol. 47, no. 4, pp. 239-243, 2008. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:220:047445. [Accessed: 04 May 2024]

Metadata
Title (english)Combined megaloblastic and immunohemolytic anemia associated - case report
AuthorVesna Vucelić
AuthorVladimir Stančić
AuthorMario Ledinsky
AuthorBiserka Getaldić
AuthorDragica Sović
AuthorJavorka Dodig
AuthorLjiljana Grbac
AuthorPetar Gaćina
AuthorGoran Rinčić
AuthorDubravka Čaržavec
Author's institution(Sestre milosrdnice University Hospital Center)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract (english)
A 55-year-old female with a history of psychosis and rheumatoid arthritis was admitted to the hospital for fatigue and dizziness. At admission, macrocytic anemia, high serum lactic acid dehydrogenase (LDH) and gastrin concentrations, decreased serum vitamin B concentration, with macroovalocytes and poikilocytes in peripheral blood smear suggested the diagnosis of pernicious anemia. Indirect antiglobulin test (IAT) was negative. Surprisingly, treatment by vitamin B and folic acid administered for two weeks was ineffective and followed by transitory worsening of hemoglobin concentration on day 8. Repeat direct antiglobulin test (DAT) and IAT were positive. This immunotransfusion conversion, suggesting the presence of autoimmune hemolytic anemia, could be explained by change in the macroblastic erythrocyte population, i.e. emerging red cells with completely exposed membrane antigens due to vitamin B treatment and/or higher degree of dysregulation of the lymphocyte clone secreting erythrocyte autoantibodies. We proposed the coexistence of pernicious and autoimmune hemolytic anemia; therefore, methylprednisolone was added to vitamin B treatment. This therapy successfully improved hemoglobin and erythrocyte concentration. Although megaloblastic-pernicious anemia is a common disease, association of pernicious and autoimmune hemolytic anemia with two mechanisms of hemolysis (ineffective erythropoiesis and immune mechanism) is a rare condition, with only several dozens of cases described so far.
Keywords (english)
Languageenglish
Publication typeScientific paper - Case study
Publication statusPublished
Peer reviewPeer review - international
Publication versionPublished version
Journal titleActa clinica Croatica
Numberingvol. 47, no. 4, pp. 239-243
p-ISSN0353-9466
e-ISSN1333-9451
URN:NBNurn:nbn:hr:220:047445
Publication2008
Document URLhttps://hrcak.srce.hr/34886
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0) icon
Created on2022-08-31 10:34:43