title: A case study of a child with chronic hemolytic anemia due to a Donath-Landsteiner positive, IgM anti-I autoantibody.
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.
authors.affiliation: Division of Transfusion Medicine, Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Karafin
authors.forename: R Sue
authors.initials: RS
authors.lastname: Shirey
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ness
authors.forename: Karen E
authors.initials: KE
authors.lastname: King
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Keefer
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood* / Q000188:drug therapy*; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*
chemical_list: D001323:Autoantibodies; C067477:Donath-Landsteiner antibody; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors