Autoimmune haemolytic anaemia and fever of undetermined origin as presenting manifestations of Hodgkin disease: A case report.

Abstract

Introduction: Autoimmune haemolytic anaemia is an important cause of acute or chronic anaemia. Its association with lymphoproliferative disorders such as non-Hodgkin lymphoma, and Hodgkin disease is well documented in the literature.
Subjects and Methods: We report a 14 year-old male adolescent who presented with protracted recurrent fever, as well as clinical and laboratory findings suggestive of autoimmune haemolytic anaemia.
Results: Patient however responded poorly to standard therapeutic interventions including steroids. Post-mortem histology revealed Hodgkin disease (lymphocyte-depletion type) as the fundamental disease- a diagnosis not strongly considered before the patient‘s death.
Recommendations: We recommend a high index of suspicion for Hodgkin disease in any patient who presents with chronic haemolytic anaemia not responding satisfactorily to treatment even in the absence of peripheral lymphadenopathy.

Key words: Autoimmune haemolytic anaemia, fever, Hodgkin disease