Warm autoimmune hemolytic anemia and hemophagocytic lymphohistiocytosis/macrophage activation syndrome occurring after COVID19 infection and administration of Casirivimab + Imdevimab (COVID19 monoclonal antibody)

Key Clinical Message Warm Autoimmune Hemolytic Anemia (WAHA) is the most common form of autoimmune hemolysis and there is a growing body of evidence of an association between SARS‐CoV‐2 infection, WAHA and a hyperinflammatory state, including hemophagocytic lymphohistiocytosis/macrophage activation...

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Bibliographic Details
Published in:Clinical case reports 2024-02, Vol.12 (2), p.e8426-n/a
Main Authors: Swartz, Andrew W., Novelli, Enrico M.
Format: Article
Language:English
Subjects:
Anemia
Blood
Case Report
Case reports
Conflicts of interest
Consent
COVID-19 vaccines
COVID‐19
Drug dosages
Hemoglobin
hemolytic anemia
Hospitals
Infections
Laboratories
Lymphatic diseases
macrophage activation syndrome
Monoclonal antibodies
monoclonal antibody
Oncology
Pandemics
Patients
Severe acute respiratory syndrome coronavirus 2
Steroids
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Summary:Key Clinical Message Warm Autoimmune Hemolytic Anemia (WAHA) is the most common form of autoimmune hemolysis and there is a growing body of evidence of an association between SARS‐CoV‐2 infection, WAHA and a hyperinflammatory state, including hemophagocytic lymphohistiocytosis/macrophage activation syndrome. However, there is no literature to date of WAHA or hyperinflammatory state following administration of anti‐SARS‐CoV‐2 monoclonal antibody treatment. This report documents a case of a patient with history of WAHA who developed brisk hemolysis and a hyperinflammatory state consistent with hemophagocytic lymphohistiocytosis/macrophage activation syndrome after COVID‐19 infection and treatment with an anti‐SARS‐CoV‐2 monoclonal antibody. He was successfully treated with multimodal treatment involving steroids, intravenous immunoglobulins, rituximab, anakinra, and vincristine with resolution of the hemolysis. Evidence of hemophagocytosis in the peripheral smear of a patient with warm autoimmune hemolytic anemia after COVID‐19 and anti‐SARS‐CoV‐2 monoclonal antibodies.
ISSN:2050-0904
2050-0904
DOI:10.1002/ccr3.8426