Plasma exchange for a hemolytic crisis due to autoimmune hemolytic anemia of the IgG warm type

Summary A patient with a hyperacute hemolytic crisis due to AIHA of the IgG type was treated by combined plasmapheresis and exchange transfusion. A discontinuous flow centrifuge was used. Immediately after the exchange the hemoglobin level rose from 2.6 to 9.8 g/dl. The D. A. T. became weakly positive and the hemolytic crisis subsided. During the days following the exchange the autoantibodies responsible for the hemolytic crisis, switched from IgG 1 and IgG 3 to IgG2 and IgG4. The clinical and laboratory picture stabilized thereafter.