• Franziska Dickmann and Uwe Janssens.
• St. Antonius-Hospital, Eschweiler, Deutschland.
• Dtsch. Med. Wochenschr. 2025 Feb 1; 150 (4): 163166163-166.

AbstractAn 83-year-old female patient presented with angina pectoris, hemoglobinuria and jaundice. Laboratory diagnostics proved difficult due to hemolysis in all blood tubes, following re-evaluation after warming the blood sample.With low haptoglobin, elevated lactate dehydrogenase and elevated indirect bilirubin, we made a suspected diagnosis of autoimmune hemolytic anemia with cold antibodies, which was confirmed through a positive Coombs test and detection of C3d-loaded erythrocytes. Complications included NSTEMI type 2 in the context of hemolysis and acute kidney damage. A Proteus mirabilis bacteremia was diagnosed as the cause of the AIHA.After treatment of the underlying infection and high-dose prednisolone therapy, the hemolysis parameters regressed and the patient could be discharged to outpatient hematologic follow-up.Interdisciplinary and multi-professional collaboration with laboratory staff and transfusion medicine is crucial for both rapid diagnosis and further treatment. Blood transfusions in AIHA should only be carried out according to strict indications.Thieme. All rights reserved.

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