Case Report
A Case of Autoimmune Hemolytic Anemia after the First Dose of COVID-19 mRNA-1273 Vaccine with Undetected Pernicious Anemia
Table 1
Laboratory test result during and after hospitalization.
| | Laboratory results | Admission | Discharge | Follow-up 1 (1 week after discharge) | Follow-up 2 (3 weeks after discharge) | Reference range |
| | WBC (×109/L) | 3.5 | 9.0 | 11.4 | 12.2 | 3.6–10.6 | | Neutrophils (%) | 27 | 93 | 86 | 90 | | | Lymphocytes (%) | 68 | 7 | 10 | 8 | | | Monocytes (%) | 3 | 0 | 4 | 1 | | | Eosinophils (%) | 0 | 0 | 0 | 1 | | | Basophils (%) | 0 | 0 | 0 | 0 | | | Myelocytes (%) | 2 | | | | | | Absolute neutrophils (×109/L) | 0.9 | 8.4 | 9.6 | 11.2 | 1.7–7.0 | | Absolute lymphocytes (×109/L) | 2.2 | 0.6 | 1.1 | 1.0 | 1–3.2 | | Absolute monocytes (×109/L) | 0.1 | 0 | 0.4 | 0.1 | 0.1–1.3 | | Absolute eosinophils (×109/L) | 0 | 0 | 0 | 0.1 | 0.0–0.3 | | Absolute basophils (×109/L) | 0 | 0 | 0 | 0 | 0.0–0.2 | | Absolute myelocytes (×109/L) | 0.1 | | | | | | Hemoglobin (g/dL) | 4.5 | 7.9 | 8.9 | 9.6 | 12–15 | | Hematocrit (%) | 12.7 | 24.1 | 27.9 | 31.2 | 35–49 | | MCV (fL) | 90 | 95 | 93 | 92 | 81–99 | | RDW (%) | >40 | 39.6 | 29.2 | 21.6 | 11.5–14.5 | | Platelets (×109/L) | 148 | 401 | 628 | 243 | 150–450 | | Schistocytes | Few (1+) | Many (3+) | None seen | None seen | None | | Polychromasia | Slight | Marked (3+) | Moderate (2+) | Slight | | | Microcytes | Many (3+) | Moderate (2+) | Few (1+) | | | | Macrocytes | Few (1+) | Moderate (2+) | Moderate (2+) | Few (1+) | | | ALT (units/L) | 36 | | | | 7–52 | | AST (units/L) | 71 | | | | 13–39 | | Total bilirubin (mg/dL) | 2.1 | | | 0.5 | 0.0–1.0 | | Indirect bilirubin (mg/dL) | 1.7 | | | 0.4 | 0.0–0.8 | | LDH (units/L) | 4332 | 2628 | 540 | 257 | 140–271 | | Haptoglobin (mg/dL) | <6 | <6 | | | 30–200 | | Serum iron (μg/dL) | 95 | | | | 50–212 | | Iron saturation (%) | 41 | | | | 15–55 | | TIBC (μg/dL) | 231 | | | | 250–400 | | Ferritin (ng/mL) | 355.4 | | | | 10–106 | | Serum B12 level (pg/mL) | <50 | | | | 200–1,000 | | Serum folate (ng/mL) | >23.0 | | | | >5.9 | | Reticulocyte count (%) | 1.4 | | 2.8 | 2.0 | 0.5–2.5 | | Absolute reticulocyte number (× 109/L) | 19.9 | | 88.2 | 69.1 | 21–115 | | Gastric parietal cell IgG (units) | 18.8 | | | | 0.0–24.9 | | Intrinsic factor antibodies | Positive | | | | Negative | | Indirect Coombs’ test | Positive | | | | Negative | | Direct Coombs’ test | Positive IgG and C3 | | | | Negative | | Antibody ID | Warm autoantibodies | | | | Negative | | Antibody eluted | Eluate positive with all cells | | | | | | Coronavirus SARS-CoV-2 PCR | Not detected | | | | |
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