Case Study#3

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Clinical Course

• Marrow - erythroid hyperplasia without other pathology
  
  
• DIAGNOSIS: warm autoimmune hemolytic anemia (AIHA); he was started on prednisone.
  
  
• He was transfused with 4 RBC units on day 2 of admission when his Hct dropped to 14%. Hemolysis continued, requiring 2 to 4 RBC units/d despite steroids. He eventually received Imuran and subsequently vincristine, to which he finally responded.
  
  
• Total number of RBC units received was 25.
  
  
• During this admission, the patient developed methicillin-resistant staphylococcal infection, successfully treated with levofloxacin and vancomycin.
  
  
• Breakpoint #3:
  Is there a unifying disease entity for this patient and how can this be established?