Pregnancy-induced hemolytic anemia with a possible immune-related mechanism.

BACKGROUND: Pregnancy-induced hemolytic anemia is a rare maternal complication that occurs during pregnancy and resolves soon after delivery. The mechanism is unclear, and the disease is often referred to as unexplained hemolytic anemia associated with pregnancy.

CASE: We report a case of life-threatening hemolytic anemia that occurred during pregnancy and resolved spontaneously soon after delivery. Direct and indirect Coombs test results were negative. Several possible causes were investigated, but all were ruled out. However, an increased immunoglobulin G level was observed in maternal red blood cells throughout pregnancy when the patient was severely anemic. The immunoglobulin G level decreased after delivery and was close to the control level on postpartum day 5.

CONCLUSION: These observations suggest that the hemolytic anemia in this patient had an immune-related etiology.