Severe hemolytic anemia in an adult associated with anti-T

An adult woman hospitalized because of a stab wound suffered a severe hemolytic crisis during which she was found to be profoundly anemic. There was evidence of increased red blood cell fragility and extravascular hemolysis. Her cells, which were T-activated, were agglutinated spontaneously in vitro by anti-T in her own plasma. They were also agglutinated by some, but not all, human anti-M and anti-N sera, and were mildly aggregated by protamine sulphate. A normal amount of H antigen was present and no agglutination occurred in saline by incomplete Rh antibodies. The findings indicate that T-activation was incomplete. It is suggested that the patient experienced a short episode of acquired autohemolytic anemia caused by the activity of her own anti-T during a period when her normal enzyme-inhibiting substances were either not present or had been rendered temporarily inactive.