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Alemtuzumab Plus Cyclosporine Treatment of the Autoimmune Hemolytic Anemia in an Adult Bowel Transplant
Joint Authors
Giudice, V.
Finelli, C.
Pironi, L.
Morelli, Cristina
Stanzani, M.
Zanfi, C.
Pasqualini, E.
Ravaioli, M.
Pinna, Antonio Daniele
Di Simone, M.
Dazzi, Alessandro
Lauro, Augusto
Source
Case Reports in Transplantation
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-08-11
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
An adult male underwent a bowel transplant for tufting enteropathy, receiving alemtuzumab, tacrolimus, and steroids as immunosuppressants.
Five years later, he developed an autoimmune hemolytic anemia (AIHA), anti-IgG positive, with reduced reticulocyte count, leukopenia, and thrombocytopenia with antiplatelet antibodies.
After an unsuccessful initial treatment with high dose steroids, reduction in tacrolimus dose, and intravenous immunoglobulin (IVIG), a bone marrow biopsy revealed absence of erythroid maturation with precursor hyperplasia.
The patient was switched to sirolimus and received four doses of rituximab plus two courses of plasmapheresis, which decreased his transfusion requirements.
After a febrile episode one month later, the AIHA relapsed with corresponding decreases in platelet and leukocyte count: cyclosporine A (CsA) was started with a second course of rituximab and IVIG without response, even though repeat bone marrow biopsy did not reveal morphology correlated to an acquired pure red cell aplasia (APRCA).
Considering the similarity in his clinical and laboratory findings to APRCA, alemtuzumab was added (three doses over a week) with CsA followed by steroids.
The patient was eventually discharged transfusion-independent, with increasing hemoglobin (Hb) levels and normal platelet and leukocyte count.
One year later he is still disease-free with functioning graft.
American Psychological Association (APA)
Lauro, Augusto& Stanzani, M.& Finelli, C.& Zanfi, C.& Morelli, Cristina& Pasqualini, E.…[et al.]. 2014. Alemtuzumab Plus Cyclosporine Treatment of the Autoimmune Hemolytic Anemia in an Adult Bowel Transplant. Case Reports in Transplantation،Vol. 2014, no. 2014, pp.1-4.
https://search.emarefa.net/detail/BIM-458498
Modern Language Association (MLA)
Lauro, Augusto…[et al.]. Alemtuzumab Plus Cyclosporine Treatment of the Autoimmune Hemolytic Anemia in an Adult Bowel Transplant. Case Reports in Transplantation No. 2014 (2014), pp.1-4.
https://search.emarefa.net/detail/BIM-458498
American Medical Association (AMA)
Lauro, Augusto& Stanzani, M.& Finelli, C.& Zanfi, C.& Morelli, Cristina& Pasqualini, E.…[et al.]. Alemtuzumab Plus Cyclosporine Treatment of the Autoimmune Hemolytic Anemia in an Adult Bowel Transplant. Case Reports in Transplantation. 2014. Vol. 2014, no. 2014, pp.1-4.
https://search.emarefa.net/detail/BIM-458498
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-458498