Référence:Post-Babesiosis Warm Autoimmune Hemolytic Anemia

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En quelques mots
Concerne les maladies : Babésiose, Anémie hémolytique auto-immune
Étudie les aspects: Symptôme
A pour fiabilité: Nouvelles données scientifiques
A pour public cible: Chercheurs
Langue: Anglais
Pays: USA
Étudie les causes: Babesia, Babésia Microti, Maladie auto-immune
Étudie les symptômes: Réponse immunitaire
Étudie les outils de diagnostic:
Étudie les traitements:
Mention spéciale pour: Alerte

Auteurs: Ann E. Woolley, Mary W. Montgomery, William J. Savage, Maureen O. Achebe, Kathleen Dunford, Sarah Villeda, James H. Maguire, Francisco M. Marty

Publié en: 2017

Lien vers l'article original: https://www.nejm.org/doi/full/10.1056/NEJMoa1612165

Résumé en Français:

Description de cas d'anémies hémolytique auto-immune après une Babésiose. Une infection dégénérant en maladie auto-immune demande un traitement totalement différent. Ce point est donc à surveiller.

Abstract en langue originale:

BACKGROUND Babesiosis, a tickborne zoonotic disease caused by intraerythrocytic protozoa of the genus babesia, is characterized by nonimmune hemolytic anemia that resolves with antimicrobial treatment and clearance of parasitemia. The development of warm-antibody autoimmune hemolytic anemia (also known as warm autoimmune hemolytic anemia [WAHA]) in patients with babesiosis has not previously been well described.

METHODS After the observation of sporadic cases of WAHA that occurred after treatment of patients for babesiosis, we conducted a retrospective cohort study of all the patients with babesiosis who were cared for at our center from January 2009 through June 2016. Data on covariates of interest were extracted from the medical records, including any hematologic complications that occurred within 3 months after the diagnosis and treatment of babesiosis.

RESULTS A total of 86 patients received a diagnosis of babesiosis during the 7.5-year study period; 18 of these patients were asplenic. WAHA developed in 6 patients 2 to 4 weeks after the diagnosis of babesiosis, by which time all the patients had had clinical and laboratory responses to antimicrobial treatment of babesiosis, including clearance of Babesia microti parasitemia. All 6 patients were asplenic (P<0.001) and had positive direct antiglobulin tests for IgG and complement component 3; warm autoantibodies were identified in all these patients. No alternative explanation for clinical hemolysis was found. WAHA required immunosuppressive treatment in 4 of the 6 patients.