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A case of hemoglobin SC disease with cold agglutinin‐induced hemolysis
Author(s) -
Inaba Hiroto,
Geiger Terrence L.,
Lasater Olga E.,
Wang Winfred C.
Publication year - 2005
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20244
Subject(s) - cold agglutinin , hemolysis , hematocrit , cold agglutinin disease , medicine , immunology , hemoglobin , coombs test , hemolytic anemia , red blood cell , anemia , haptoglobin , antibody , autoantibody
Abstract Children with sickle cell disease commonly require red blood cell (RBC) transfusion. We report the first case of hemoglobin (Hb) SC disease with development of severe anemia induced by cold agglutinin hemolysis after Mycoplasma infection. Complete blood count (CBC) showed falsely decreased RBC count and hematocrit and falsely elevated MCV and MCHC. Peripheral blood smear showed RBC clumping at room temperature; this disappeared after warming to 37°C. Anti C3b‐C3d was present on red cells, and indirect antiglobulin test revealed a circulating cold agglutinin. Furthermore, anti‐ Mycoplasma pneumoniae IgM antibody was detected in serum. Careful evaluation of CBCs and peripheral blood smears is required in cases of worsening anemia among sickle cell patients and consideration should be given to cold hemagglutinin disease as an etiology. Am. J. Hematol. 78:37–40, 2005. © 2004 Wiley‐Liss, Inc.