Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy
Purpose: While Partial Splenic Artery Embolization (PSAE) is a useful procedure that has been performed for a variety of indications including trauma and hypersplenism, it has only been rarely described as a treatment for Idiopathic Warm Autoimmune Hemolytic Anemia. Previous reports in the literatur...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-07-01
|
| Series: | The Arab Journal of Interventional Radiology |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/AJIR.AJIR_33_19 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850056246117269504 |
|---|---|
| author | Mohamad Omar Hadied Riyad Yazan Kherallah Mariam Salman Khalid Eteer Scott Schwartz |
| author_facet | Mohamad Omar Hadied Riyad Yazan Kherallah Mariam Salman Khalid Eteer Scott Schwartz |
| author_sort | Mohamad Omar Hadied |
| collection | DOAJ |
| description | Purpose: While Partial Splenic Artery Embolization (PSAE) is a useful procedure that has been performed for a variety of indications including trauma and hypersplenism, it has only been rarely described as a treatment for Idiopathic Warm Autoimmune Hemolytic Anemia. Previous reports in the literature are limited to case reports in situations that include the patient being a poor surgical candidate, the inability to transfuse blood during surgery because of autoantibodies, and a patient's refusal of blood products on religious grounds. Materials and Methods: A case report describing the case of a 27-year-old male diagnosed with idiopathic warm Autoimmune Hemolytic Anemia treated successfully with partial splenic artery embolization (PSAE) as a bridging therapy to definitive surgical splenectomy. Results: The patient's pre-procedure hemoglobin was 2.1 g/dl. The first hemoglobin post-procedure was 4.5 g/dl. After embolization, the patient remained in the inpatient setting for eight days for close observation. During the inpatient hospitalization the patient's hemoglobin continued to trend upwards until it stabilized around 6 g/dl. Inpatient laboratory workup also showed increasing haptoglobin, and decreasing LDH. After discharge, the patient developed persistent pain two months post-procedure. An elective splenectomy was scheduled three months after the embolization procedure to address the persistent pain. Six months' post embolization procedure and three months postoperatively, the patient is doing well clinically with a hemoglobin of 14 g/dl. Conclusion: In conclusion, this case demonstrates the utility of a Partial Splenic Artery Embolization (PSAE) as an acute life-saving intervention for poor surgical candidates with idiopathic warm Autoimmune Hemolytic Anemia (AIHA) refractory to medical therapy. |
| format | Article |
| id | doaj-art-e6390d5ebc3d4245983519daf04624eb |
| institution | DOAJ |
| issn | 2542-7075 2542-7083 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Arab Journal of Interventional Radiology |
| spelling | doaj-art-e6390d5ebc3d4245983519daf04624eb2025-08-20T02:51:45ZengWolters Kluwer Medknow PublicationsThe Arab Journal of Interventional Radiology2542-70752542-70832020-07-0140213013310.4103/AJIR.AJIR_33_19Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical TherapyMohamad Omar Hadied0Riyad Yazan Kherallah1Mariam Salman2Khalid Eteer3Scott Schwartz4Department of Radiology, Henry Ford Health System, Detroit, MI, USADepartment of Internal Medicine, Baylor College of Medicine Medical Center, Houston, TX, USAUniversity of Michigan Medical School, Ann Arbor, MI, USASchool of Medicine, Wayne State University, Detroit, MI, USADepartment of Radiology, Henry Ford Health System, Detroit, MI, USAPurpose: While Partial Splenic Artery Embolization (PSAE) is a useful procedure that has been performed for a variety of indications including trauma and hypersplenism, it has only been rarely described as a treatment for Idiopathic Warm Autoimmune Hemolytic Anemia. Previous reports in the literature are limited to case reports in situations that include the patient being a poor surgical candidate, the inability to transfuse blood during surgery because of autoantibodies, and a patient's refusal of blood products on religious grounds. Materials and Methods: A case report describing the case of a 27-year-old male diagnosed with idiopathic warm Autoimmune Hemolytic Anemia treated successfully with partial splenic artery embolization (PSAE) as a bridging therapy to definitive surgical splenectomy. Results: The patient's pre-procedure hemoglobin was 2.1 g/dl. The first hemoglobin post-procedure was 4.5 g/dl. After embolization, the patient remained in the inpatient setting for eight days for close observation. During the inpatient hospitalization the patient's hemoglobin continued to trend upwards until it stabilized around 6 g/dl. Inpatient laboratory workup also showed increasing haptoglobin, and decreasing LDH. After discharge, the patient developed persistent pain two months post-procedure. An elective splenectomy was scheduled three months after the embolization procedure to address the persistent pain. Six months' post embolization procedure and three months postoperatively, the patient is doing well clinically with a hemoglobin of 14 g/dl. Conclusion: In conclusion, this case demonstrates the utility of a Partial Splenic Artery Embolization (PSAE) as an acute life-saving intervention for poor surgical candidates with idiopathic warm Autoimmune Hemolytic Anemia (AIHA) refractory to medical therapy.http://www.thieme-connect.de/DOI/DOI?10.4103/AJIR.AJIR_33_19splenic artery embolizationautoimmune hemolytic anemicaembolizationanemia |
| spellingShingle | Mohamad Omar Hadied Riyad Yazan Kherallah Mariam Salman Khalid Eteer Scott Schwartz Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy The Arab Journal of Interventional Radiology splenic artery embolization autoimmune hemolytic anemica embolization anemia |
| title | Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy |
| title_full | Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy |
| title_fullStr | Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy |
| title_full_unstemmed | Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy |
| title_short | Partial Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy |
| title_sort | partial splenic artery embolization for idiopathic warm autoimmune hemolytic anemia refractory to medical therapy |
| topic | splenic artery embolization autoimmune hemolytic anemica embolization anemia |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/AJIR.AJIR_33_19 |
| work_keys_str_mv | AT mohamadomarhadied partialsplenicarteryembolizationforidiopathicwarmautoimmunehemolyticanemiarefractorytomedicaltherapy AT riyadyazankherallah partialsplenicarteryembolizationforidiopathicwarmautoimmunehemolyticanemiarefractorytomedicaltherapy AT mariamsalman partialsplenicarteryembolizationforidiopathicwarmautoimmunehemolyticanemiarefractorytomedicaltherapy AT khalideteer partialsplenicarteryembolizationforidiopathicwarmautoimmunehemolyticanemiarefractorytomedicaltherapy AT scottschwartz partialsplenicarteryembolizationforidiopathicwarmautoimmunehemolyticanemiarefractorytomedicaltherapy |