title: Haemolytic anaemia in previously healthy adult patients with CMV infections: report of two cases and an evaluation of subclinical haemolysis in CMV mononucleosis.
abstract: Whereas haemolytic anaemia is commonly encountered in infants and young children with cytomegalovirus (CMV) infections, it is an infrequent complication of CMV-induced infections in previously healthy adults. The data from 2 such patients are presented. One patient's Hb fell to a level of 36 g/l, and she required prednisone and blood transfusions. Her direct antihuman globulin test (DAT) was positive (IgG), and her red blood cell survival (51Cr) revealed a T 1/2 of 5 d. Both saline-agglutinating and low-molecular-weight cold agglutinins (CA) (4 degrees C) that reacted against both cord and adult cells were identified. In the second case, a moderate haemolytic anaemia (lowest Hb 87 g/l) was accompanied by negative DAT and CA studies. 20 other patients with CMV-mononucleosis were evaluated for evidence of subclinical haemolysis. Reticulocyte counts greater than 3.0% were noted in 9 of these patients. Haptoglobin values were below 0.5 g/l in 13 patients, and a positive DAT was recorded in 3/10 cases. This study documents haemolysis in many non-immunosuppressed adult patients with CMV infections. The mechanism responsible remains obscure.
mesh_terms: D000293:Adolescent; D000328:Adult; D000743:Anemia, Hemolytic / Q000209:etiology* / Q000628:therapy; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis; D001803:Blood Transfusion; D003176:Complement C3 / Q000032:analysis; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006461:Hemolysis; D006801:Humans; D007244:Infectious Mononucleosis / Q000503:physiopathology*; D008259:Macroglobulins / Q000032:analysis; D008297:Male; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D003176:Complement C3; D008259:Macroglobulins; D005492:Folic Acid; D011241:Prednisone