Hemolytic anemia as a sequela of arsenic intoxication following long-term ingestion of traditional Chinese medicine

Abstract

We report on a 51-yr-old woman who developed intravascular hemolytic anemia caused by arsenic after long-term ingestion of a traditional Chinese medicine (TCM). Twelve years before the admission, she was diagnosed as neurocysticercosis. She has ingested a TCM for about 12 yr instead of undergoing medical therapy for the disease. She was presented with a severe Coombs'-negative hemolytic anemia with hemosiderinuria. The urine arsenic level was elevated suggesting the arsenic intoxication as a cause of the anemia. She was treated successfully with therapeutic red cell exchange without any sequelae.

Fig. 1

Bone marrow biopsy shows mild hypocellular marrow with 40% cellularity (A) (H&E stain, ×100) and erythroid hyperplasia (B) (H&E stain, ×400).