Complement-mediated autoimmune haemolytic anaemia as an initial presentation of Legionnaires’ disease

A 42-year-old diabetic man presented to the hospital with severe sepsis and multiorgan dysfunction. A probable respiratory source of sepsis was suspected because of suggestive clinical and radiological findings. He was critically ill and was therefore admitted to intensive care for further managemen...

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Veröffentlicht in:BMJ case reports 2021-08, Vol.14 (8), p.e243023
Hauptverfasser: Sabahat, Uzma, Shaikh, Niaz Ahmed, Alameen, Ali Mohammed Mahmood, Ashfaq, Faryal
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Shaikh, Niaz Ahmed
Alameen, Ali Mohammed Mahmood
Ashfaq, Faryal
description A 42-year-old diabetic man presented to the hospital with severe sepsis and multiorgan dysfunction. A probable respiratory source of sepsis was suspected because of suggestive clinical and radiological findings. He was critically ill and was therefore admitted to intensive care for further management including ventilatory support and renal replacement therapy. He was also found to have marked anaemia requiring multiple blood transfusions with clinical and laboratory evidence pointing towards severe haemolysis. Further workup for the aetiology of pneumonia established a diagnosis of Legionella by confirmatory tests namely legionella antigen in the urine and exponentially rising serum antibody titres. The cause for the severe haemolysis was found to be complement-mediated autoimmune haemolysis as determined by direct antiglobulin test positive for complement components C3 and negative for IgG. Such clinically significant autoimmune haemolysis as a presenting feature, rather than a late complication, has never before been reported in the literature.
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subjects Abdomen
Adult
Anemia
Anemia, Hemolytic, Autoimmune - complications
Anemia, Hemolytic, Autoimmune - diagnosis
Anemia, Hemolytic, Autoimmune - therapy
Antibiotics
Antibodies
Antigens
Arthritis
Bacterial infections
Blood transfusions
Case Report
Case reports
Cold
Complement C3
Cytomegalovirus
Dehydrogenases
Disease
Emergency medical care
Hemoglobin
Hemolysis
Hepatitis C
Hospitalization
Hospitals
Humans
Infections
Intensive care
Laboratories
Legionnaires' disease
Legionnaires' Disease - complications
Legionnaires' Disease - diagnosis
Male
Pneumonia
Sepsis
Tuberculosis
Urine
title Complement-mediated autoimmune haemolytic anaemia as an initial presentation of Legionnaires’ disease
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