THE FAMILIAL occurence of auto-immune hemolytic anemia has been rarely observed, and only three convincing reports have been published.1-3 Extensive serological examination of asymptomatic family members has been undertaken in one instance.3 The observation that there was an increased incidence of serological abnormalities suggests that genetic factors may play a more significant role in the pathogenesis of auto-immune hemolytic anemia than has been previously recognized.
In 1963 a brother and sister with severe Coombs' positive hemolytic anemia were evaluated by the Division of Hematology, Washington University, School of Medicine. A third sibling, who died in 1949, had a history compatible with hemolytic anemia. The implication of these observations led to an evaluation of a number of consanguineous and nonconsanguineous family members. The case histories of the three affected siblings together with information compiled in the study of the asymptomatic relatives comprise the substance of this report.