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Examination revealed severe pallor, mild icterus, elevated jugular venous pressure, generalised lymphadenopathy and hyperpigmentation. Investigations revealed severe anaemia, indirect hyperbilirubinaemia, raised LDH and negative Coombs test. Antinuclear antibody and anti-dsDNA, anti-Sm and anti-SS-A\/Ro antibodies were positive and complement C3 was low. The patient was diagnosed to have systemic lupus erythematosus and immune-mediated intravascular haemolysis and was treated with prednisolone and hydroxychloroquine. Haemolysis resolved following steroid therapy, and during follow-up, there were no further episodes of haemolysis.<\/jats:p>","DOI":"10.1136\/bcr-2021-244459","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T12:19:57Z","timestamp":1629461997000},"page":"e244459","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Immune-mediated Coombs negative intravascular haemolysis in systemic lupus erythematosus (SLE)"],"prefix":"10.1136","volume":"14","author":[{"given":"Bhoobalan","family":"Magendiran","sequence":"first","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustine","family":"Jose","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 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