Direct antiglobulin test negative autoimmune hemolytic anemia associated with autoimmune hepatitis

A case of direct antiglobulin test(DAT)-negative autoimmune hemolytic anemi a (AIHA) associated with autoimmune hepatitis (AIH) is presented. A 54-year -old female was admitted with liver dysfunction and anemia. AIH was diagnos ed based on the diagnostic criteria of the International Autoimmune Hepatit is Group. The patient was DAT-negative, and exhibited all the clinical feat ures of warm type AIHA and elevated levels of red blood cell-associated IgG . Marked improvement of subjective symptoms, the return to normal of hemato logical and liver test values, and a decrease in the level of RBC-associate d IgG were observed after the start of corticosteroid therapy. Although an association of AIH and AIHA is rarely reported, the measurement of RBC-asso ciated IgG is recommended in cases of AIH with DAT-negative anemia, as both disorders are autoimmune in nature. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.