Transfusion support in a severe autoimmune hemolytic anemia patient associated with systemic lupus erythematosus and antiphospholipid syndrome

A positive direct antiglobulin test is a criterion for the diagnosis of systemic lupus erythematosus (SLE). In general, severe hemolysis is absent in SLE. Sometimes, these patients may show hemolysis when presenting with antiphospholipid syndrome (APS). It is essential to exclude an underlying alloantibody along with autoantibody. We had reported a case of a 24-year-old female SLE along with an APS patient requiring transfusion support with underlying allo-anti-S antibody. We provided two units of S antigen-negative best-matched units to the patient who tolerated it well and showed improvement.