β-thalassemia intermedia with autoimmune hemolytic anemia and multiple cholelithiasis complications

Abstract

The most recommended treatment for β-thalassemia is blood transfusion, but this treatment leads to a number of complications such as iron overload, transfusion reactions, infections, alloimmunization, and formation of autoantibodies. Autoimmune hemolytic anemia (AIHA) in β-thalassemia where alloimmunization reactions occur due to repeated transfusions is an extremely rare complication with only 5% of cases. In this case report, the patient responded well to corticosteroids and cyclosporine. The risk of alloimmunization in patients with β-thalassemia who receive transfusions can be minimized by screening for suitable genotypes, antibodies, and phenotypes prior to transfusion. Meanwhile, cholelithiasis is described as one of the most common complications of thalassemia; of 261 patients, the total prevalence of cholelithiasis was 20.3%. Typical cholelithiasis in thalassemia is black pigment stones. Asymptomatic cholelithiasis does not require treatment as its course and progression to symptomatic disease is relatively low. This case report discusses about a 23-year-old woman with β-thalassemia intermedia who developed complications of AIHA and cholelithiasis.

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