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Off-label use of the terminal complement pathway inhibitor, eculizumab, led to rapid amelioration of the haemolysis, presumably by the inhibition of an intravascular component, and allowed time for slower acting immunosuppressive agent to take effect. This novel approach warrants further evaluation, given the poor prognosis of multirefractory wAIHA.<\/jats:p>","DOI":"10.1136\/bcr-2018-226429","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e226429","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Severe refractory idiopathic warm autoimmune haemolytic anaemia responsive to complement inhibition with eculizumab"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1648-8664","authenticated-orcid":false,"given":"Lucy","family":"Neave","sequence":"first","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Haematology, Barnet Hospital, Royal Free London NHS Foundation Trust, Hertfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxine","family":"Lissack","sequence":"additional","affiliation":[{"name":"Department of Haematology, Barnet Hospital, Royal Free London NHS Foundation Trust, Hertfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Scully","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,12,13]]},"reference":[{"key":"2025082707445943000_11.1.e226429.1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/bjh.14478","article-title":"The diagnosis and management of primary autoimmune haemolytic anaemia","volume":"176","author":"Hill","year":"2017","journal-title":"Br J Haematol"},{"key":"2025082707445943000_11.1.e226429.2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1159\/000439002","article-title":"New insights in the pathogenesis of Autoimmune Hemolytic Anemia","volume":"42","author":"Barcellini","year":"2015","journal-title":"Transfus Med Hemother"},{"key":"2025082707445943000_11.1.e226429.3","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1159\/000438964","article-title":"Role of complement in Autoimmune Hemolytic Anemia","volume":"42","author":"Berentsen","year":"2015","journal-title":"Transfus Med Hemother"},{"key":"2025082707445943000_11.1.e226429.4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-11-693689"},{"key":"2025082707445943000_11.1.e226429.5","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.114561"},{"key":"2025082707445943000_11.1.e226429.6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-583021"},{"key":"2025082707445943000_11.1.e226429.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061648"},{"key":"2025082707445943000_11.1.e226429.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208981"},{"key":"2025082707445943000_11.1.e226429.9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.molimm.2017.05.013","article-title":"Complement in clinical medicine: clinical trials, case reports and therapy monitoring","volume":"89","author":"Ricklin","year":"2017","journal-title":"Mol Immunol"},{"key":"2025082707445943000_11.1.e226429.10","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1182\/blood.V126.23.274.274","article-title":"Complement Inhibition with Eculizumab in Patients with Cold Agglutinin Disease (CAD): results from a prospective phase II trial (DECADE Trial)","volume":"126","author":"R\u00f6th","year":"2015","journal-title":"Blood"},{"key":"2025082707445943000_11.1.e226429.11","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-01-196329"},{"key":"2025082707445943000_11.1.e226429.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1800-7"},{"key":"2025082707445943000_11.1.e226429.13","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/ajh.23791","article-title":"Refractory warm IgM-mediated autoimmune hemolytic anemia associated with Churg-Strauss syndrome responsive to eculizumab and rituximab","volume":"90","author":"Chao","year":"2015","journal-title":"Am J Hematol"},{"key":"2025082707445943000_11.1.e226429.14","first-page":"1","article-title":"Refractory IgG warm autoimmune hemolytic anemia treated with eculizumab: a novel application of anticomplement therapy","volume":"2016","author":"Ma","year":"2016","journal-title":"Case Rep Hematol"},{"key":"2025082707445943000_11.1.e226429.15","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1046\/j.1537-2995.1987.27187121473.x","article-title":"Evidence suggesting the occurrence of C3-independent intravascular immune hemolysis. 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