All issues > Volume 9(5); 1966

Case Report

J Korean Pediatr Soc. 1966;9(5):303-308. Published online September 30, 1966.

A Case of Autohemolytic Anemia Complicated to Viral Pneumonia

Koo Chang Chung¹, Young Zu Cho¹, Tai Hee Kwon¹, Dong Shlk Chin¹, Duk Yong Kang²

¹Department of Pediatrics,College of Medicine, Ewha Womans University
²Department of Clinical Pathology,College of Medicine,Ewha Womans University

Abstract

A one year-old female infant of autohemolytic anemia during the course of viral pneumonia is presented. Acute respiratory symptoms and signs were begining on Nov.-16, 1964 and followed by active hemolytic episode one month later; such as anemia with extremely low level of hemoglobin, jaundice with moderately elevated direct and indirect bilirubin levels in serum, increased urobilinogen amount in urine and feces, marked reticulocytosis, hepatosplenomegaly and positive Coombs test. Direct Coombs test revealed strongly positive reaction without the presense of prozone phenome-non, but by means of the indirect Coombs test, incomplete antibodies (so-called autoantibodies) were 1 also more active in only lower dilution at 20° C than at 37° C, same pattern in acidified patient’s serum at 20° C, these are indicated the presense of incomplete antibodies of the cold agglutinin type. Further more, antibody studies with O CDe/cDE test cells also revealed that the agglutination: between the patient's serum and the known red cell of group O blood was more active at a temperature of 4°C, then more at 20° C than at 37° C. The patient has been placed on the treatment of adequate blood transfusion, which was more. frequently needed initialy, then total more than 10 times during 12 months until,last blood transfusion was performed on Dec. -15, 1965, and prolonged oral use of prednisolone 15mg per day. Subsequently no hemolytic evidences are found up to the present, June 30, 1966. At the present, moderate hepatomegaly, frequent cough with U.R.I. and under nourished status are still troublesome for the patient. Further close observation, therefore, may be needed for a long time.

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