Recurrence of paroxysmal cold hemoglobinuria in a boy after physical cooling for fever.
Hemolysis and hemoglobinuria after direct exposure to cold has rarely been reported in paroxysmal cold hemoglobinuria (PCH). The authors describe a 2.5-year-old boy with PCH (Donath-Landsteiner autoimmune hemolytic anemia), in whom 16 days after presentation, the hemoglobinuria and hemolysis recurred, when he was subjected to physical cooling, as a means to control fever associated with hospital-acquired croup. The hemolysis resolved with warmth, and administration of dexamethasone. PCH should be suspected in children with hemolytic anemia and positive direct antiglobulin test for complement. Avoidance of cold in the recovery period is imperative to prevent recurrences, whereas a short course of corticosteroids may be of benefit in suppressing the antibody production.
Department of Pediatrics, Democritus University of Thrace and University General District Hospital of Alexandroupolis, Thrace, Greece. emantada@med.duth.gr
Elpis
E
Mantadakis
Zoe
Z
Bezirgiannidou
George
G
Martinis
Athanassios
A
Chatzimichael
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001833:Body Temperature Regulation; D002675:Child, Preschool; D003080:Cold Temperature; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D005334:Fever / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D006457:Hemoglobinuria, Paroxysmal / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D006461:Hemolysis; D006801:Humans; D008297:Male; D012008:Recurrence; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D003907:Dexamethasone