A RARE CAUSE OF RECURRENT HAEMOLYTIC ANAEMIA: CARBOPLATIN AND PACLITAXEL-INDUCED AUTOIMMUNE HAEMOLYTIC ANAEMIA

Drug-induced immune haemolytic anaemia (DIIHA) is a rare but serious complication affecting approximately 1 in 1,000,000 patients, but its incidence might be underestimated due to misdiagnosis. Several factors should be considered to ensure an accurate diagnosis, including previous medical history, comorbidities, drug history, the temporal relationship between drug exposure and symptom onset, haemolytic features, and comorbidities in suspected cases. The authors report a case of DIIHA caused by combination chemotherapy with carboplatin and paclitaxel complicated with haeme pigment-induced acute kidney injury. LEARNING POINTS: Drug-induced immune haemolytic anaemia (DIIHA) should be suspected in patients with abrupt immune haemolytic anaemia with a temporal relationship between drug exposure and symptom onset. The main management of DIIHA consists of urgent discontinuation of the suspected drug and supportive treatment with close monitoring, resulting in a favourable outcome in most cases; the role of corticosteroids in DIIHA remains unclear. Haeme pigment-induced acute kidney injury is induced by intravascular haemolysis where urinalysis reveals elevated haemoglobin.