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Old 01-10-2013, 02:15 AM   #1
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Question haemolytic anemia with enlarged spleen

I have been diagnosed with haemolytic anemia. Coombs test, direct and indirect, is negative. Hemoglobin was 5 one week ago, after 3 bottles of blood it is 9.2 now. No malaria, no typhoid. Retic Count is 7. Spleen is enlarged. I suffer from fever twice/thrice a day daily (ranging 99-102 farnheit).

what is this all phenomena and what are the remedies.

 
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Old 01-10-2013, 02:22 AM   #2
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Re: haemolytic anemia with enlarged spleen

This level of anemia is pretty severe, so I hope you are under the care of a hematologist. There are several conditions that can cause anemia of this type along with fever. The cause needs to be investigated thoroughly. Please be sure your workup includes testing for systemic lupus, as that is a common cause of fever and hemolytic anemia.

 
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Old 01-10-2013, 02:57 AM   #3
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Re: haemolytic anemia with enlarged spleen

Is not it true that 'systemic lupus' is a type of autoimmune disease and in case of autoimmune diseases the Coombs tests should be positive? Also, I don't have rashes on my body.

History:
About 2 months ago, I was infected with typhoid virus and was treated with related antibiotics for 7 days. After 7 days typhoid test was negative. But from that time onwards, I never got rid of fever.

 
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Old 01-10-2013, 08:03 AM   #4
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Re: haemolytic anemia with enlarged spleen

Typhoid can cause hemolytic anemia. Have you had stool culture and sensitivity or antibody testing for typhoid to see if you still have the infection? That would make sense to repeat treatment for it, making sure the bacteria is sensitive to the antibiotic used, and the antibiotic doesn't cause hemolytic anemia as well. Do you have diarrhea and other symptoms of typhoid still? Are you seeing an infectious disease DR? I hope you get some answers soon. It is true that in lupus the Coombs is usually positive.

 
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Old 01-11-2013, 12:52 AM   #5
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Re: haemolytic anemia with enlarged spleen

no stool culture and sensitivity or antibody testing for typhoid yet but I have had blood culture test which was fine.

Secondly, I was given typhoid/malaria antibiotics for 7-8 more days after the typhoid was clear. I mean when they checked that there is no typhoid virus in the blood but the fever kept coming again and again, then during the early diagnosis they kept giving me anti-fever + anti-typhoid for more 7 days.

So, should the infection not have been finished till now after so much antibiotics?

is stool culture and sensitivity or antibody testing for typhoid required in my case?

 
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Old 01-13-2013, 08:28 AM   #6
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Re: haemolytic anemia with enlarged spleen

I have haemolytic anemia with an enlarged spleen and have had it for 7 years. The doctors do not know what causes this problem. Initially I was treated with Prednisolone (Steroids), which did not work very well, I was then given Azathioprine which stabilised my condition and I was stabilised for 5 years. Unfortunately last June it came back with a vengeance and my blood dropped to 7 and I had to have a number of blood transfusions. The hospital has just given me a drug called Octagam which has brought my blood back to normal. Unfortunately this drug only lasts for 4 weeks and I am having the second course now.

I have been doing some research and have found that a drug used in eye treatment can cause this immune problem. The drug is called Chloramphenicol. I had eye treatment just prior to getting the condition and had eye treatment again in June when it re-occurred. Did you have any eye treatment before you were diagnosed?

 
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Old 01-13-2013, 10:36 AM   #7
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Re: haemolytic anemia with enlarged spleen

No. I did not have any eye treatment before.

Last edited by nabeelkhan; 01-13-2013 at 10:37 AM.

 
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Old 02-07-2013, 03:27 AM   #8
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Re: haemolytic anemia with enlarged spleen

at last the bone marrow test revealed plasmodium vivax infection. My hemoglobin dropped to 5 and I had 3 more bottles of red packed cells.

 
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Old 02-07-2013, 04:14 AM   #9
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Re: haemolytic anemia with enlarged spleen

I am so glad a test finally confirmed what the problem was, and you can get treated and better! Yours is a very unusual case.

 
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Old 02-08-2013, 02:51 AM   #10
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Re: haemolytic anemia with enlarged spleen

The malaria treatment is continued but now a days I again feel difficulty breathing. Doctors say that I have developed chest infection and my lungs are infected ( something like water in the lungs ). They are giving me injections to increase my urine and emit the excess water. My hemoglobin again reduced to 7 PLUS the albumin level in my body is reduced significantly. The doctors say that I must have red cells transfusion and human albumin transfusion to increase them otherwise the blood stores in the body will be empty and i would not be able to create blood in the future.

 
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Old 02-08-2013, 08:12 AM   #11
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Re: haemolytic anemia with enlarged spleen

The low albumin is contributing to the water in the lungs. After the albumin infusion, the water will go back into the blood stream where it belongs and your lungs will clear faster. I would eat lots of protein, which helps replenish your albumin from your diet as well. Having malaria makes one so sick you often don't eat well, then develop nutritional deficiencies along with the infection. You have been through a lot of serious stuff. I'm very glad you are diagnosed, on treatment, and on your way to getting better. Be patient, as this takes months to resolve and recuperate from, but you'll get there!

 
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