title: Infantile cytomegalovirus-associated autoimmune hemolytic anemia.
abstract: Autoimmune hemolytic anemia (AIHA) is a hematologic disorder that is rarely seen in infants and young children. Most cases are associated with viral or bacterial infection, but the immunologic events leading to hemolysis are poorly understood. We describe two infants with severe cytomegalovirus (CMV)-associated warm antibody AIHA. One case was immunohematologically analyzed and showed suggestive evidence that endogenous anti-CMV IgG antibodies were the pathogenic antibodies leading to hemolysis, implicating a possible causal relationship between AIHA and CMV infection. Both patients were ultimately treated with intravenous CMV immune globulin, with subsequent improvement. These cases suggest that investigation for the presence of CMV in infantile AIHA is warranted and that CMV immune globulin should be considered as a therapeutic option.
authors.affiliation: Hematology and Oncology Center, Cook Children's Medical Center, Fort Worth, Texas 76104, USA. jmurray@cookchildrens.org
authors.forename: J C
authors.initials: JC
authors.lastname: Murray
authors.forename: J C
authors.initials: JC
authors.lastname: Bernini
authors.forename: H L
authors.initials: HL
authors.lastname: Bijou
authors.forename: S N
authors.initials: SN
authors.lastname: Rossmann
authors.forename: D H
authors.initials: DH
authors.lastname: Mahoney
authors.forename: A B
authors.initials: AB
authors.lastname: Morad
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000209:etiology* / Q000628:therapy; D000914:Antibodies, Viral / Q000097:blood / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000097:blood / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D003298:Coombs Test; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D007106:Immune Sera; D007116:Immunization, Passive; D007074:Immunoglobulin G / Q000276:immunology; D007223:Infant; D008775:Methylprednisolone / Q000627:therapeutic use; D009305:Nasopharynx / Q000821:virology; D014556:Urine / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D007106:Immune Sera; D007074:Immunoglobulin G; D008775:Methylprednisolone