Autoimmune Hemolytic Anemia Revealing Sarcoidosis: A Case Report
Tounsi Haifa
Department of Internal Medicine, Mohamed Taher Al Maamouri Hospital. Faculty of Medicine of Tunis, El Manar University, Nabeul, Tunisia.
Bouzouaya Hela *
Plastic and Esthetic Surgery Department Nabeul Hospital, Faculty of Medicine of Tunis. El Manar University, Tunisia.
Feten Sbai
Department of Internal Medicine, Mohamed Taher Al Maamouri Hospital. Faculty of Medicine of Tunis, El Manar University, Nabeul, Tunisia.
Hamdi Mohamed Salah
Department of Internal Medicine, Mohamed Taher Al Maamouri Hospital. Faculty of Medicine of Tunis, El Manar University, Nabeul, Tunisia.
Ghachem Ikbel
Biology Laboratory, Mohamed Taher Maamouri Hospital, Faculty of Medicine of Tunis, El Manar University, Nabeul, Tunisia.
Sbaihi Siwar
Department of Medical Imaging, Faculty of Medicine of Tunis, Mohamed Taher Al Maamouri Hospital, El Manar University, Nabeul, Tunisia.
Amri Raja
Department of Internal Medicine, Mohamed Taher Al Maamouri Hospital. Faculty of Medicine of Tunis, El Manar University, Nabeul, Tunisia.
Sbai Mohamed Ali
Plastic and Esthetic Surgery Department Nabeul Hospital, Faculty of Medicine of Tunis. El Manar University, Tunisia.
*Author to whom correspondence should be addressed.
Abstract
Hematological involvement in sarcoidosis is often characterized by lymphopenia and splenomegaly. However, auto-immune hemolytic anemia associated with sarcoidosis is scarcely reported. Herein, we report a novel case of this unusual clinical presentation.
A 40-year-old female was admitted for a normocytic and regenerative anemia. The Coombs test was positive for anti-IgG attesting of its auto-immune origin. The CT scan showed multiple mediastinal and abdominal lymphadenopathies and a bilateral interstitial pattern in the lung. Further investigations were negative for infectious diseases, malignancies and auto-immune diseases. Labial biopsy showed the presence of a non-caseating granulomatosis supporting the diagnosis of systemic sarcoidosis. The association between the two conditions was deemed fortuitus. Oral steroids were used to achieve remission for both sarcoidosis and auto-immune hemolytic anemia.
Keywords: Sarcoidosis, autoimmune hemolytic anemia, autoimmunity