PERNICIOUS ANEMIA ASSOCIATED WITH AUTOIMMUNE HEMOLYTIC ANEMIA

A 61-year-old woman with hemolytic anemia was admitted to our hospital. Laboratory findings were as follows: Hb 8.8g/dl, Ht 25.7%, mean corpuscular volume (MCV) 133.9 mean corpuscular hemoglobin (MCH) 45.8. The total bilirubin level was 4.1mg/dl (indirect 3.4mg/dl), the LDH value was 271lu/l, and the haptoglobin level was less than 10mg/dl. The direct antiglobulin (Coombs') test was positive. Serum vitamin B12 was 45pg/dl. Antiparietal cell antibodies and antiintrinsic antibodies were positive. The patient was successfully treated with vitamin B12 injection under a diagnosis as pernicious anemia associated with autoimmune hemolytic anemia. Although both pernicious anemia and autoimmune hemolytic anemia are thought to be caused by autoimmune mechanisms, reported case of pernicious anemia associated with autoimmune hemolytic anemia is very rare.