Agranulocytosis and mixed-type autoimmune hemolytic anemia in primary sjögren's syndrome: a case report and review of the literature

Int J Rheum Dis. 2016 Dec;19(12):1351-1353. doi: 10.1111/1756-185X.12803. Epub 2015 Dec 14.

Abstract

Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease that presents with sicca symptoms of the main mucosal surfaces. Patients with pSS have a broad spectrum of laboratory features, such as cytopenias and hypergammaglobulinemia. Although hematological abnormalities are usually seen in pSS patients, agranulocytosis and autoimmune hemolytic anemia (AIHA) are rare. Here we describe a 40-year-old woman with pSS who developed both agranulocytosis and mixed-type AIHA. An increased risk of malignancies has also been reported in pSS patients with hematological changes. Although there is no evidence of malignancies, this patient should be closely followed up in case of developing lymphoma.

Keywords: Sjögren's syndrome; agranulocytosis; autoimmune hemolytic anemia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adult
  • Agranulocytosis / blood
  • Agranulocytosis / diagnosis
  • Agranulocytosis / drug therapy
  • Agranulocytosis / immunology*
  • Anemia, Hemolytic, Autoimmune / blood
  • Anemia, Hemolytic, Autoimmune / diagnosis
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anemia, Hemolytic, Autoimmune / immunology*
  • Drug Substitution
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Leukocyte Count
  • Platelet Count
  • Pulse Therapy, Drug
  • Sjogren's Syndrome / blood
  • Sjogren's Syndrome / diagnosis
  • Sjogren's Syndrome / drug therapy
  • Sjogren's Syndrome / immunology*
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Immunosuppressive Agents