Thromboembolism Early After Glucocorticoid Administration in Patients with Autoimmune Hemolytic Anemia

Pulmonary embolism and deep venous thrombosis (PE/DVT) are well-known lethal complications in autoimmune hemolytic anemia (AIHA). However, the impact of their treatment is unclear. Here, we describe three elderly Japanese patients with AIHA who developed PE/DVT early after glucocorticoid administration. All patients presented with active hemolysis and high D-dimer levels upon admission. Thromboembolism was confirmed within 2 weeks after starting glucocorticoid, suggesting that both active hemolysis and glucocorticoid administration synergistically contributed to the development of PE/DVT. Clinicians should consider that such synergism may increase the risk of thromboembolism in patients with AIHA, and prophylactic anticoagulation is worth considering in patients after starting glucocorticoid.