Drug-induced autoimmune hemolytic anemia in pregnancy: A case report

Abstract

Introduction. About 10 - 20% of patients taking methyldopa therapy for more than 4 months develop autoantibodies to antigens on the surface of their own red blood cells, while less than 1% develop autoimmune hemolytic anemia. Methyldopa-induced red cell autoantibodies not associated with autoimmune hemolytic anemia are five times more common in pregnant women than in non-pregnant women. Case Report. We present a case of methyldopa-induced immune hemolytic anemia in a 23-year-old woman in her first pregnancy with and an estimated gestational age of 30 weeks. The woman presented with obesity and preeclampsia and there was no information that she has ever received a blood transfusion. The hemoglobin concentration was 10.8 g/dL. The woman started taking methyldopa tablets in the twelfth week of pregnancy and 14 weeks later she developed anemia. Warm type autoantibodies were detected in the 30th week of gestation. Conclusion. Although methyldopa- induced hemolytic anemia is rare during pregnancy, it is necessary to monitor pregnant women who take this therapy, because only discontinuation of the drug leads to termination of hemolysis and correction of anemia.