Case report: serologic confirmation of paroxysmal cold hemoglobinuria

A child with a history of recent viral infection entered the hospital with severe anemia, hemoglobinuria, and suspected autoimmune disease. Serologic findings included a positive direct antiglobulin test and incompatible crossmatches. Extensive studies, including a Donath-Landsteiner test, confirmed paroxysmal cold hemoglobinuria. The child was transfused several times with washed red blood cells compatible by prewarm technique. Although hemolysis continued after each transfusion, he stabilized and went home 5 days after his hospital admission. He reportedly made a complete recovery.