Figure 1: Hemoglobin levels (―) and RBC transfusion (arrows) during the first 3 weeks of hospitalization. No reportable hemoglobin levels (gray line) could be obtained between day 5 and day 8 due to severe RBC autoagglutination that interfered with laboratory testing. Patient received manual whole blood exchange (WBEx) with 12 units reconstituted WB (triangle) starting late on day 7 through day 8 Immunosuppression included methprednisolone (Day 1-13), prednisone (starting day 14), and 4 weekly doses of rituximab starting on day 10 (gray diamonds).