Volume: 4 Issue: 1
Year: 2016, Page: 54-56,
Introduction: The occurrence of Systemic lupus erythematosus (SLE) with Autoimmune hemolytic anemia (AIHA) has been only rarely reported in patients with Beta thalassemia trait.We here report a case of SLE presented with history of fever, giddiness associated with headache for three months and on physical examination revealed rash all over the body. On routine hemogram parameters indicated anemia with low blood indices, leucopenia, reticulocytosis, positive coombs test. In view of prolonged fever with rash, LE cell preparation, anemia with erythrocytosis and low blood indices Hemoglobin Electrophoresis was advised which showed positive LE cells in peripheral blood and hemoglobin electrophoresis suggestive of Beta thalassemia trait. Physicians should be alerted to the possible association of hemolytic anemia underlying SLE & Beta thalassemia trait so as not to delay correct diagnosis and initiation of appropriate treatment. We present this case as the occurrence of connective tissue diseases, in particular SLE, has only been rarely reported in patients with thalassemia minor. Peripheral smear findings with hemolytic picture gives clue for underlying SLE and Beta thalassemia minor.
Keywords: Auto immune hemolytic anemia, Systemic lupus erythematosus, Beta thalassemia minor.
1. Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL, Loscalzo J.Harrison’s Principles of Internal Medicine 17th Edition, Mc Graw Hill.2000;1102-1103.
2. Michel M, Habibi A, Godeau B, Bachir D, Lahari A, Galacteros F, Fifi-Mah A, Arfi S: Characteristic and outcome of connective tissue diseases in patients with sickle cell disease: report of 30 cases. Semin Arthritis Rheum 2008; 38:228–240.
3. Castellino G, Govoni M, Trotta F. Beta-thalassemic trait and systemic lupus erythematosus. Clin Exp Rheumatol 2004;22:382–3.
4. Kaloterakis A, Filiotou A, Haziyannis S. Sickle cell/b °- Thalassemia and systemic lupus erythematosus. Lupus 1999;8:778–81.
5. Wheatherall DJ, Clegg JB. The thalassemia syndromes. 4th ed. Oxford, England: Blackwell Science Ltd, 2001; 250-52.
6. Hahn Bh et al. “Systemic lupus erythematosus,” Harrison’sPrinciples of Internal Medicine,Anthony Fauci, L. Stephen Hauser, and L. Dan Longo, Eds.,McGraw-Hill, New York, NY,USA, 17 edition, 2008; 1140-42.
7. Tagoe C, Shah A, Yee H, Belmont HM. Aplastic anemia in systemic lupus erythematosus: a distinct presentation of acquired aplastic anemia? J Clin Rheumatol. 2001;7(6):377–383.
8. Giannouli S, Voulgarelis M, Ziakas PD, Tzioufas AG. Anaemia in systemic lupus erythematosus: from pathophysiology to clinical assessment. Ann Rheum Dis. 2006;65(2):144–148.
9. Hargraves, M. M.: Production in vitro of the L.E. cell phenomena; use of normalbone marrow elements and blood plasma from patients with acute disseminated lupus erythematosus. Proc. Mayo Clin., 1949;24,:234.
10. Saxena VR, Mina R, Moallem HJ, Rao SP, Miller ST. Systemic lupus erythematosus in children with sickle cell disease. J Pediatr Hematol Oncol2003;25:668–71.
11. St Clair EW. Anti-La antibodies. Rheum Dis Clin North Am1992;18:359–76.
12. Advani R, Sorenson S, Shinar E, Lande W, Rachmilewitz E, Schrier SL. Characterization and comparison of the red blood cell membrane damage in severe human a and ß thalassemia. Blood1992;74:2194.
13. Altinoz M.A. Gedkogh g,deniz Betaa thalasemia association with autoimmune disease.Immunophamacol Immunotoxicol 2011; 21 (79) :375.
Majed, Amitha, Anamika, Sandhya. Systemic lupus erythematosus with Autoimmune Hemolytic anemia in a 37-year old patient with Betathalassemia trait. Perspectives in medical research 2016;4:1:54-56.