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Fatal warm autoimmune hemolytic anemia in a child due to IgM‐type autoantibodies
Author(s) -
Takahashi Hiroyuki,
Tanaka Fumiko,
Sakuma Hiroyuki,
Sato Mutsumi,
Inaba Shoichi,
Kai Sumio
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12931
Subject(s) - medicine , autoimmune hemolytic anemia , autoantibody , jaundice , immunology , plasmapheresis , hemolytic anemia , coombs test , anemia , antibody , gastroenterology
Herein is described a case of immunoglobulin M (IgM) warm autoimmune hemolytic anemia (AIHA) in a child who consequently died within 3 days of clinical onset. A previously healthy 11‐year‐old boy presented with fever, anemia, jaundice, and deteriorating consciousness. On direct agglutination test against group O red blood cells, agglutination was seen even at 37°C in saline, which was abolished on dithiothreitol treatment of the serum, indicating that the responsible autoantibody was IgM and had a warm‐reactive capacity. A diagnosis of IgM warm AIHA was therefore made. Hemagglutination in the visceral capillaries was considered as the direct cause of organ dysfunction. The patient died due to respiratory failure. IgM warm AIHA is a very severe condition that is difficult to reverse in an advanced state. Both prompt, definite diagnosis and intervention are therefore vital to prevent severe multi‐organ dysfunction in cases of IgM warm AIHA.