A case study of a child with chronic hemolytic anemia due to a Donath-Landsteiner positive, IgM anti-I autoantibody

Pediatric Blood & Cancer
Matthew S KarafinJeffrey Keefer

Abstract

In children, paroxysmal cold hemoglobinuria (PCH) is generally considered an acute self-limited autoimmune hemolytic anemia caused by an IgG biphasic auto-anti-P antibody identified by the Donath-Landsteiner (D-L) test. We report a case of a 5-year-old female with a chronic hemolytic anemia. The etiology of the hemolysis appears to be an unusual D-L positive, IgM antibody with specificity for the I antigen. The clinical course is described and a discussion of PCH and the D-L antibody is presented. We also discuss intravenous immunoglobulin infusions as a therapy for children with this form of severe chronic autoimmune hemolytic anemia.

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Citations

Jun 9, 2015·Pediatric Blood & Cancer·Nicholas S WhippleKerri A Nottage
Jun 9, 2017·Transfusion·Laura L Cooling
Nov 19, 2019·Blood Advances·Sarah A Lau-BraunhutMatt S Zinter
Apr 4, 2017·Transfusion·Sara D PrinceDavid F Friedman
Aug 27, 2021·Archives of Disease in Childhood. Education and Practice Edition·Jennifer Delun WilliamsMark Peter Tighe

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Autoimmune Hemolytic Anemia

Autoimmune hemolytic anemia (AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to an insufficient number of oxygen-carrying red blood cells in the circulation. Discover the latest research on AIHA here.