PE (pulmonary embolism) is a life-threatening complication rarely seen in the AIHA (autoimmune haemolytic anaemia) patients. Herein we reported a rare and serious AIHA-PE patient characterised by extensive peripheral pulmonary embolism on CTPA. A 59-year-old woman presented to our ED (emergency department) complaining of acute chest pain and dyspnea. During her presentation in ED she experienced a sudden syncope and soon developed CA (cardiac arrest). Laboratory studies showed a increase of CK-MB,troponin T,myoglobin and D-dimer. Computed tomography pulmonary angiography (CTPA) showed no large central or segment pulmonary emboli but increased RV (right ventricle)size,enlarged main pulmonary artery and invisible peripheral pulmonary artery. She was diagnosed with acute PE and alteplase was delivered intravenously. After thrombolytic therapy she remained hypotension and developed worsening anaemia. Detailed examination for anaemia revealed AIHA. She was discharged in a stable condition after 5 weeks with methylprednisolone and warfarin. Hb, D-dimer and transthoracic echocardiography showed complete recovery at 3-months follow up. PE attributed to AIHA is characterized by subsegment and distal pulmonary artery embolism which is easily neglected but always life-threatening. This case also highlights the PE as a secondary diagnosis should be evaluated comprehensively in order to identify the underlying pathogenesis.

中文翻译：

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急性外周性肺栓塞归因于自身免疫性溶血性贫血：一例病例报告。

PE（肺栓塞）是一种威胁生命的并发症，在AIHA（自身免疫性溶血性贫血）患者中很少见。本文中，我们报道了一位罕见且严重的AIHA-PE患者，其特征在于CTPA上广泛的周围性肺栓塞。一名59岁的妇女因急症性胸痛和呼吸困难而出现在我们的急诊科。在急诊室就诊期间，她突然晕厥并很快发展为CA（心脏骤停）。实验室研究显示CK-MB，肌钙蛋白T，肌红蛋白和D-二聚体增加。计算机断层扫描肺血管造影（CTPA）显示无大的中央或节段性肺栓塞，但RV（右心室）大小增加，主肺动脉增大和周围肺动脉不可见。她被诊断出患有急性PE，并且阿替普酶经静脉给药。溶栓治疗后，她仍处于低血压状态，贫血恶化。贫血的详细检查显示AIHA。用甲基泼尼松龙和华法林治疗5周后病情稳定。血红蛋白，D-二聚体和经胸超声心动图检查显示在3个月的随访中完全恢复。归因于AIHA的PE的特征是亚节段和远端肺动脉栓塞，该栓塞很容易被忽略，但始终会危及生命。这种情况也突出了PE，作为次要诊断应进行全面评估，以确定潜在的发病机理。D-二聚体和经胸超声心动图检查在随访3个月后完全恢复。归因于AIHA的PE的特征是亚节段和远端肺动脉栓塞，该栓塞很容易被忽略，但始终会危及生命。这种情况也突出了PE，作为次要诊断应进行全面评估，以确定潜在的发病机理。D-二聚体和经胸超声心动图检查显示3个月后完全恢复。归因于AIHA的PE的特征是亚节段和远端肺动脉栓塞，该栓塞很容易被忽略，但始终会危及生命。这种情况也突出了PE，作为次要诊断应进行全面评估，以确定潜在的发病机理。