CASE I. AUTOIMMUNE HEMOLYTIC ANEMIA (AIHA)
A. TYPE II AUTOIMMUNE REACTION
Direct Coombs test was positive. Haptoglobin (a scavenger of free hemoglobin) was reduced to <5mmol/L (normal 10-30 mmol/L). Parvovirus B19, thyroid stimulating hormone (TSH), vitamin B12 level, folate level, iron profile, and ferritin were unremarkable. A review of her blood smear showed numerous spherocytes (spherical erythrocytes instead of the usual biconcave disc shape, the result of damage to the red cell membrane as it passes through the spleen and confirmed thrombocytopenia (low numbers of platelets). An ultrasound of her abdomen revealed a normal liver but an enlarged spleen.