In patients infected with Human Immunodeficiency Virus (HIV), cytopenia and bone marrow dysplasia are the most common hematologic complications. Autoimmune Hemolytic Anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells through warm or cold antibodies. Despite Autoimmune Hemolytic Anemia (AIHA) being a rare disease in children, and anemia in HIV patients being multifactorial, HIV infection can predispose to AIHA. Literature review reveals the occurrence of AIHA in People Living with HIV (PLWH) and most of the reported cases are in adults on treatment with HAART (Highly active antiretroviral therapy).

We aim to present a rare case of an Omani infant presenting with fever and progressive pallor. AIHA was identified as the cause of anemia and subsequently the patient was diagnosed to have underlying HIV infection.