Autoimmune hemolytic anemia caused by IgG lambda-monotypic cold agglutinins of anti-Pr specificity after rubella infection.
BACKGROUND
In postinfection cold agglutinin (CA) disease, a relation between CA specificity and the underlying infectious agent has been observed. The induction of anti-I by Mycoplasma pneumoniae and that of anti-i by EBV are well-established examples.


METHODS
A 5-year-old boy developed severe hemolytic anemia after serologically ascertained rubella infection. Hemolysis was caused by high-titer CAs, which were analyzed by absorption and elution with sialidase-treated RBCs and hemagglutination-inhibition experiments.


RESULTS
After elimination of normal anti-I and anti-T, the predominant CA was found to be an IgG lambda autoantibody with anti-Pr(1) specificity.


CONCLUSIONS
This case seems to be of interest because it is the first report of severe CA-induced hemolysis after rubella infection, it is the first description of an IgG lambda-monotypic CA, and, along with previous case reports (three established and three suspected cases), it indicates a relationship between rubella infection and the CA specificity anti-PR:
König
A L
AL
Institute of Transfusion Medicine, Katharinenhospital, Stuttgart, Germany.
Schabel
A
A
Sugg
U
U
Brand
U
U
Roelcke
D
D
D000373:Agglutinins / Q000276:immunology*; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology*; D001323:Autoantibodies / Q000276:immunology*; D002648:Child; D003450:Cryoglobulins; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D012409:Rubella / Q000150:complications* / Q000276:immunology*; D012412:Rubella virus / Q000276:immunology*
D000373:Agglutinins; D001323:Autoantibodies; D003450:Cryoglobulins; D007074:Immunoglobulin G; C029443:cold agglutinins