A Case of COVID-19-Associated Autoimmune Hemolytic Anemia With Hyperferritinemia in an Immunocompetent Host

Zoha Huda; Abdullah Jahangir; Syeda Sahra; Muhammad Rafay Khan Niazi; Shamsuddin Anwar; Allison Glaser; Ahmad Jahangir

doi:10.7759/cureus.16078

A Case of COVID-19-Associated Autoimmune Hemolytic Anemia With Hyperferritinemia in an Immunocompetent Host

Cureus. 2021 Jun 30;13(6):e16078. doi: 10.7759/cureus.16078. eCollection 2021 Jun.

Authors

Zoha Huda¹, Abdullah Jahangir², Syeda Sahra³, Muhammad Rafay Khan Niazi³, Shamsuddin Anwar², Allison Glaser⁴, Ahmad Jahangir⁵

Affiliations

¹ Medicine, The City University of New York (CUNY) School of Medicine, New York, USA.
² Internal Medicine, Staten Island University Hospital, Northwell Health, New York, USA.
³ Internal Medicine, Northwell Health, New York, USA.
⁴ Infectious Disease, Northwell Health, New York, USA.
⁵ Internal Medicine, Mayo Hospital, Lahore, PAK.

Abstract

We report an interesting case of a middle-aged gentleman who presented with diabetic ketoacidosis (DKA) and tested polymerase chain reaction (PCR) positive for COVID-19 infection. His hospital stay was complicated by acute kidney injury, hematuria, and normocytic anemia. Initial chest x-ray demonstrated bibasilar opacities. D-dimer and C-reactive protein were elevated. During his hospital stay, his hemoglobin decreased from 13.4 g/dL to 9 g/dL, and further workup demonstrated ferritin of 49,081 ng/mL with lactate dehydrogenase of 1665 U/L. He was treated with prednisone and folic acid for autoimmune hemolytic anemia (AIHA). Ferritin was downtrended, and hemoglobin stabilized. As demonstrated by this case report and prior literature review, COVID-19 infection can be associated with AIHA.

Keywords: autoimmune hemolytic anemia (aiha); covid-19; hemolytic anemia; high ferritin; hyperferritinemia.

Publication types

Case Reports