A 51-year-old woman presented with severe headache and severe anemia. She was diagnosed with autoimmune hemolytic anemia (AIHA) and treated with prednisolone and red blood cell transfusion. During the clinical course, the patient developed acute transient neurological symptoms. Magnetic resonance angiography revealed multifocal segmental narrowing of the cerebral arteries, which improved spontaneously on follow-up. The clinical and radiological findings were consistent with reversible cerebral vasoconstriction syndrome (RCVS). This case highlights that multiple factors, including active hemolysis, red blood cell transfusion, and corticosteroid therapy, may contribute to the development of RCVS.
Sato et al. (Thu,) studied this question.