Neoehrlichiosis Causing Hemolytic Anemia in Patients Treated with Rituximab, Norway, 2024-2025.
Martin Paulson, Christine Wennerås, Hanne Quarsten et al.
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Case in brief
Three rituximab-treated patients in Norway presented with direct antiglobulin test-negative hemolytic anemia due to Neoehrlichia mikurensis infection. Symptoms included splenomegaly and night sweats, with hemolysis severity varying from mild to severe, necessitating transfusions and splenectomy in one case. All patients achieved complete resolution of symptoms following a 21-day doxycycline treatment.
Diagnostic / clinical pearl
Neoehrlichiosis should be considered as a potential cause of hemolytic anemia in patients treated with rituximab, especially in endemic regions.