Q: My 29 years old daughter has been diagnosed with Crohn's and autoimmune haemolytic anaemia. Whenever the anaemia occurs blood transfusion is being given. Is there any other alternative to cure the disease?

A:A Direct antiglobulin (Coombs)-positive haemolytic anaemia is quite rare with Crohn’s disease and there are very limited case reports. The usual cause of anaemia in such patients is nutritional deficiency anaemia due to iron or folic acid &/or vitamin B12 deficiency and anaemia of chronic disease. In case your daughter has a positive direct antiglobulin test, then a trial of steroids can be given failing which immunomodulators (like methotrexate, cyclosporine or tumour necrosis factor-a antibody used for treatment of primary disease) may be tried. In case of refractoriness, surgical treatment of Crohn’s disease may relieve the haemolytic anaemia.