title: Severe Hemolytic Anemia Following Intravenous Immunoglobulin in an Infant With Kawasaki Disease.
abstract: Severe hemolytic anemia (HA) is an uncommon adverse reaction of intravenous immunoglobulin (IVIg) administration. Previous reports assume that antibodies contained in IVIg preparations are the cause of hemolysis. We report a 10-month-old infant with Kawasaki disease who was treated with high-dose IVIg and developed severe HA. The patient's Rh blood type was D+C+c+E-e+. He developed anti-C and anti-e antibodies following treatment with IVIg, and, after considering all possible causes of hemolysis, we concluded that this was a case of autoimmune HA induced by immunoglobulin treatment. The hyperinflammatory condition associated with Kawasaki disease may have contributed to the severity of anemia.
authors.affiliation: *Department of Pediatrics, Kyushu University Hospital, Fukuoka †Department of Pediatrics ‡Division of Clinical Laboratory, Fukuoka Higashi Medical Center, Koga, Japan.
authors.forename: Vlad
authors.initials: V
authors.lastname: Tocan
authors.forename: Akari
authors.initials: A
authors.lastname: Inaba
authors.forename: Tamami
authors.initials: T
authors.lastname: Kurano
authors.forename: Motoshi
authors.initials: M
authors.lastname: Sonoda
authors.forename: Keiji
authors.initials: K
authors.lastname: Soebijanto
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000096:biosynthesis* / Q000276:immunology; D017707:Erythrocyte Transfusion; D006386:Hemagglutination Tests; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D007223:Infant; D007518:Isoantibodies / Q000008:administration & dosage / Q000276:immunology; D007519:Isoantigens / Q000276:immunology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000628:therapy*; D011239:Prednisolone / Q000627:therapeutic use; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; D007519:Isoantigens; D012204:Rh-Hr Blood-Group System; D011239:Prednisolone