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Recurrent Donath‐Landsteiner hemolytic anemia: a pediatric case report
Author(s) -
Prince Sara D.,
Winestone Lena E.,
Nance Sandra J.,
Friedman David F.
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14032
Subject(s) - medicine , hemolysis , antibody , immunology , autoimmune hemolytic anemia , hemolytic anemia , hemoglobinuria , hemolytic disease of the newborn (abo) , gastroenterology , pregnancy , biology , fetus , genetics
BACKGROUND Paroxysmal cold hemoglobinuria (PCH) is a form of autoimmune hemolytic anemia caused by the Donath‐Landsteiner antibody (D‐L antibody). In children, this is typically a transient immune‐mediated hemolysis that follows a viral illness and does not recur. Recurrent acute or chronic PCH due to D‐L antibody is very rare. CASE REPORT We have reported a unique case of recurrent PCH in a 5‐year‐old boy with two acute episodes of hemolysis separated by 21 months of hematologic remission. Each episode was severe requiring red blood cell transfusions, intravenous methylprednisolone, and intravenous immunoglobulin during the second episode. Testing identified recurrence of the D‐L antibody with the classic anti‐P biphasic hemolysis. CONCLUSION This demonstrates that PCH can be a recurrent disease in the pediatric population (in the absence of syphilis) with the classical D‐L antibody.