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Positive Coombs test - AIHA - and relation to blood transfusions
On 1 Nov I had a negative coombs test.
On 2 Nov I had my first RBC and platelet transfusion
On 18 Nov I had my second and last RBC transfusion
On Tuesday (18 Dec) with a retic count of 3.5 and my hemoglobin falling my doctors thought I must have developed PNH. So they ran tests for PNH. The PNH came back as negative (slight reading of below 1%). But another test (haptoglobin) came back with a low reading so they decided to check for coombs and the coombs test came back positive. So they ran additional tests which showed that I am positive for warm auto-immune hemolytic anemia (WAIHA) but at this stage the reading is only a slight positive. Who knows whether it has only just developed or whether I have had for a few weeks.
My hgb is sitting at around 8.1 to 8.5 and has been at this level for about the past week with a retic count increasing over the past 2 weeks from 2 to 3.5 (possibly higher today as still waiting on result). It is the increasing retic count and the hgb not responding that generated the concern from the doctors.
The doctors are thinking it could be a reaction to the rbc transfusions or a possibility that my body has developed a reaction to the cyclosporine. I would be interested to know whether anyone else has encountered this scenario.
The good news is that just over a month post ATG my platelets are at 82 and ANC at 1.45. I stopped prednisone about 12 days ago but have started again today due to the WAIHA.
Has anyone encountered this?
It feels like I take a couple of steps forward and then a few step back.
Last edited by TASHMAC : Sat Dec 22, 2012 at 07:54 AM.
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