A unique case series of pediatric autoimmune hemolytic anemia

Autoimmune hemolytic anemia (AIHA) is a group of hematological disorders where there is autoantibody mediated destruction of red blood cells which can be life threatening and if not appropriately treated can lead to fatality. Early diagnosis with aggressive work up and timely multipronged management is the key to success. Here we present four cases of diverse etiology - one each of post SARS-CoV-2 AIHA, Idiopathic AIHA, Drug induced AIHA and Common variable immunodeficiency (CVID) (exome sequencing proven) associated Evans syndrome. All these patients were treated with steroids as the first line agent while the child of CVID required immunosuppressive therapy. This case series re-emphasizes the need to look for diverse etiologies in AIHA. The role of the new advanced modality like whole exome sequencing is also emphasized for definitive diagnosis if it is affordable in certain circumstances.