A Less Common but Lethal Encounter: Mixed Autoimmune Hemolytic Anemia Unmasking Angioimmunoblastic T-cell Lymphoma

Autoimmune hemolytic anemia (AIHA) is a spectrum of acquired hemolytic disorders caused by autoantibodies targeting red blood cells, leading to their destruction and anemia. Mixed AIHA, characterized by both warm and cold autoantibodies, is a rare and complex condition, often presenting diagnostic challenges. Angioimmunoblastic T-cell lymphoma (AITL), a subtype of peripheral T-cell lymphoma, is also uncommon and can be associated with autoimmune cytopenias. We present a case of a 48-year-old male patient diagnosed with mixed AIHA and AITL after presenting with generalized weakness, jaundice, and bicytopenia. Diagnosis was confirmed through positive Coombs tests for warm and cold antibodies, lymph node biopsy, and imaging. Despite initial response to glucocorticoids, the patient experienced complications following chemotherapy initiation, leading to a fatal outcome. This case highlights the importance of early recognition of mixed AIHA and AITL and the complexities involved in their management.