All issues > Volume 34(6); 1991

Original Article

J Korean Pediatr Soc. 1991;34(6):826-831. Published online June 30, 1991.

A case of pancytopenia associated with mycoplasmal pneumonia.

Young Mee Yoo¹, Beom Soo Park¹, In Sang Jeon¹, Hee Young Shin¹, Hyo Seop Ahn¹, Se Jung Sohn²

¹Department of Pediatrics, Seoul Nationl University College of Medicine, Seoul, Korea
²Department of Pediatrics, Choong Ang Kil Hospital, Incheon, Korea

Received: October 17, 1990;  Accepted: December 15, 1990.

Abstract

Mycoplasma pneumoniae infection is manifestated as pneumonia and extra-pulmonary symptoms such as hematologic, neurologic, gastrointestinal, musculoskeletal, dermatologic and cardiac manifes- tations. Among the hematologic changes, hemolytic anemia is most frequently seen. Throm- bocytopenic purpura, lymphocytosis or rarely lymphopenia, elevated erythrocyte sedimentation rate, positive direct Coombs test, reticulocytosis and DIC are known hematologic features. This 12 years old female patient was presented with pneumonia and pancytopenia. Bone marrow biopsy showed less than 10% cellularity which was compatible with aplastic anemia. Chest X-ray finding revealed patchy hazy density in superior and lateral segments of the left lower lobe with collapse. On the fourth hospital day, cold agglutinin titer was 1:1,024 and anti-mycoplasma antibody titer was 1:5,120. On the thirteenth hospital day, with improvement of pneumonia, those titers became 1: 512 and 1:5,120 respectively. Gradually reticulocyte count increased and the features of hemolytic anemia became more prominent with improvement of chest X-ray and symtoms after treatment with antibiotics. We concluded that she sufferred with mycoplasmal pneumonia and the initial pancytopenia was the ‘aplastic crisis’ of hemolytic anemia which was caused by Mycoplasma pneumoniae infection (pneumonia).

Keywords :Mycoplasmal infection;Pancytopenia;Coombs positive hemolytic anemia