Hemolytic anemia in native valve infective endocarditis: a rare case report and review of literature.

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Manju, V.D Dogra, Dhiraj Kapoor, Gaveshna, Gopal Singh*, “Hemolytic anemia in native valve infective endocarditis: a rare case report and review of literature”., ijmhs, vol. 10, no. 01, pp. 785–788, Jan. 2020.
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Abstract

Hemolytic anemia (HA) is not a common presentation in infectious
endocarditis (IE) and has only been reported in very few cases. Although
diseased valves may cause shearing stress that fragments RBCs, similar to that
associated with mechanical heart valves, an autoimmune hemolytic process has
also been implicated. We reported a case of patient who had HA secondary to
acute IE due to MRSA. The anemia completely resolved after treating the (IE) .
The cause was most likely mechanical shearing (schistocytes or fragmented
RBCs present on peripheral smear) by the large vegetation on native valve ;
autoimmune hemolysis was considered unlikely in this case due to consistently negative Coombs tests and failure to respond to corticosteroids.

 

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References

1.Lee GR: The anemia of chronic disease.Semin Hematol 1983; 20: 61-80 2.Toom S, Xu Y. Hemolytic anemia due tonative valve subacute endocarditis withActinomyces israellii infection. Clin CaseRep 2018;6: 376-79. 3.Maeda T, Ashie T, Kikuiri K, FukuyamaS, Yamaguchi Y, Yoshida E, et al:Fragmentation hemolysis in a patientwith hypertrophic obstructivecardiomyopathy and mitral valveprolapse. Jpn Circ J 1992; 56: 970-74 4.Nishiura T, Miyazaki Y, Oritani K,Tominaga N, Tomiyama Y, Katagiri S, etal: Aspergillus vegetative endocarditiscomplicated with schizocytic hemolyticanemia in a patient with acutelymphocytic leukemia. Acta Haematol1986; 76: 60-62 5.Naidoo DP, Seedat MA, Vythilingum S:Isolated endocarditis of the pulmonaryvalve with fragmentation haemolysis. BrHeart J 1988; 60: 527-29 6.Inada T, Shirono K, Tsudo H: Hemolyticanemia in a patient with subacutebacterial endocarditis due to Streptococcus sanguis. Acta Haematol 1995; 94: 95-97 7.Gradon JD, Hirschbein M, Milligan J:Fragmentation hemolysis: an unusualindication for valve replacement in nativevalve infective endocarditis. South Med J1996; 89: 818-20

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References

1.Lee GR: The anemia of chronic disease.Semin Hematol 1983; 20: 61-80
2.Toom S, Xu Y. Hemolytic anemia due tonative valve subacute endocarditis withActinomyces israellii infection. Clin CaseRep 2018;6: 376-79.
3.Maeda T, Ashie T, Kikuiri K, FukuyamaS, Yamaguchi Y, Yoshida E, et al:Fragmentation hemolysis in a patientwith hypertrophic obstructivecardiomyopathy and mitral valveprolapse. Jpn Circ J 1992; 56: 970-74
4.Nishiura T, Miyazaki Y, Oritani K,Tominaga N, Tomiyama Y, Katagiri S, etal: Aspergillus vegetative endocarditiscomplicated with schizocytic hemolyticanemia in a patient with acutelymphocytic leukemia. Acta Haematol1986; 76: 60-62
5.Naidoo DP, Seedat MA, Vythilingum S:Isolated endocarditis of the pulmonaryvalve with fragmentation haemolysis. BrHeart J 1988; 60: 527-29
6.Inada T, Shirono K, Tsudo H: Hemolyticanemia in a patient with subacutebacterial endocarditis due to
Streptococcus sanguis. Acta Haematol 1995; 94: 95-97
7.Gradon JD, Hirschbein M, Milligan J:Fragmentation hemolysis: an unusualindication for valve replacement in nativevalve infective endocarditis. South Med J1996; 89: 818-20

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