Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 6 S1 2022 07 06 288 291 Vajihe Marsusi Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ashraf Sadat Jamal Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Laleh Eslamian Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maasoumeh Saleh Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Behnaz Nouri Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran. Danial Dehghan Department of Obstetrics and Gynecology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran. 2021 02 13 2021 04 14 Autoimmune hemolytic anemia (AIHA) may be the first manifestation of systematic lupus erythematosus (SLE). Antierythrocyte antibodies in SLE are mainly warm-type Immunoglobulin G (IgG), but mixed-type AIHA is also reported. Cold antibody-mediated hemolytic anemia is extremely rare in SLE. Only a few cases have been reported in the literature. A 37-year-old pregnant woman presented with features of hemolytic anemia and was later diagnosed as an SLE case. Although rare, a new case report highlights that cold-type autoimmune hemolytic anemia may be an early manifestation of SLE. https://crcp.tums.ac.ir/index.php/crcp/article/view/482