Korean J Clin Pathol.  2000 Feb;20(1):110-112.

A Case of Severe Low-Titer Cold-Hemagglutinin Disease

• Won DI
• Kwon OK
• Yoon KJ
• Kim HM

Abstract

Most patients suffering from acute cold-hemagglutinin disease(CHAD) have cold-agglutinin titers well over 1000 which respond poorly to corticosteroids treatment. However, good results with corticosteroids have been reported in some patients with severe low-titer CHAD. We report the case of severe low-titer CHAD which responded well to corticosteroids treatment. A 7-year-old girl with unremarkable prior history was admitted in July 1999 with a three-day history of high fever and black-colored urine. Direct antiglobulin test using polyvalent and anti-C3d monovalent antisera were positive. Cold-agglutintin titer was as high as 1:256 at 4degrees C, 1:32 at 25degrees C and less than 1:4 at 37degrees C. The serum contained cold autoantibodies against both adult and cord blood erythrocytes. Washed and prewarmed red blood cells were transfused. The girl experienced prompt relief of fever and hemolysis and improvement of her general condition after corticosteroids treatment.

Keyword

Low-titer cold-hemagglutinin disease; Hemolysis; Corticosteroids

MeSH Terms

Adrenal Cortex Hormones
Adult
Autoantibodies
Chad
Child
Coombs Test
Erythrocytes
Female
Fetal Blood
Fever
Hemolysis
Humans
Immune Sera
Adrenal Cortex Hormones
Autoantibodies
Immune Sera