Q: I had headache for around 4 days and was anemic. The blood test done on 08.04.02 which showed hemoglobin as 8.0. Subsequent blood test done on 10.4.02 morning revealed that the hemoglobin was 4.2 and it dropped down to 2.4 by the same night. Immediately I was shifted to ICU of a hospital, referred to a hemotologist and started treatment with Prednisolone inj. I was shifted to the ward after 5 days after some improvement in the hemoglobin level. Subsequently, I was prescribed Prednisolone tablets, 40mg per day alongwith Shellcal, Cobadex forte & pentocid tablets. The cause for the sudden drop of hemoglobin and self destruction of RBC is unknown. It was diagnosed as Auto Immune Hemolytic Anemia. Could you please throw some light on this condition and prevention of recurrence of this ailment.

A:A sudden drop in haemoglobin concentration is either due to haemolysis (destruction of blood cells) or due to acute blood loss. As the history does not suggest acute blood loss it is likely that the sudden fall in haemoglobin was due to acute haemolysis. There are many causes of acute haemolysis. In autoimmune haemolytic anaemia direct antiglobulin test also referred to as direct Coombs test is positive. In the absence of it the diagnosis is presumptive. The results of lab. tests are not provided; I therefore, cannot shed any more light. In all cases of acute blood loss G-6-Pd deficiency should be excluded. It is uncommon in females. As the patient is a female it is unlikely though not totally absolutely so.