UNREMITTING SEVERE AUTOIMMUNE HEMOLYTIC-ANEMIA AS A PRESENTING FEATURE OF HODGKINS-DISEASE WITH MINIMUM TUMOR LOAD

Two patients are reported who presented with severe autoimmune haemoly tic anaemia (AIHA) of warm antibody type, with poor response to treatm ent. Extensive investigations failed to find a cause in both cases. In one case therapeutic splenectomy, one year after the initial presenta tion, showed Hodgkin's disease (HD) in the spleen but nowhere else. Th e second patient died of unremitting AIHA almost two years after the p resentation and I-ID was found in only one mediastinal lymphnode at au topsy. These cases illustrate that a minimum tumour load of HD undetec table by the usual investigations can be associated with life-threaten ing AIHA.