[Mycoplasma pneumonia associated with hemolytic anemia: case report and literature review]

To improve the understanding of hemolytic anemia secondary to Mycoplasma pneumonia.

One case of hemolytic anemia secondary to Mycoplasma pneumonia in an adult was reported. With "Mycoplasma pneumonia, hemolytic anemia, adult, case report" as the search terms, and the search time ranged from 1967.1 to 2011.3 for PubMed and 1978.1 to 2011.3 for Wanfangdata, 9 cases of similar clinical cases in the literatures were reviewed.

A 29 year-old female patient was admitted to the hospital because of fever with cough and sputum production for 15 days. The chest X-ray showed pneumonia on the left lower lung. On day 14, the patient's hemoglobin decreased, to a minimum of 83 g/L, and the reticulocyte was 0.04, and the blood agglutinated in the tube. The IgM antibody for mycoplasma was positive, and the cold agglutinin titer was 1:256. After antibiotic therapy, the level of hemoglobin increased and the lesions of the lung recovered. The diagnosis was mycoplasma pneumonia associated with hemolytic anemia. Nine adult cases of mycoplasma pneumonia associated with hemolytic anemia were collected by review of the literature. Of the 10 cases, 6 was male and 4 was female, age was from 29 to 60. In 8 of the 10 cases, hemolytic anemia occurred in 8 - 18 days, and the cold agglutinin titer increased in all cases, 1:1024 or more in 7 cases. Endovascular thrombosis occurred in 2 cases. Nine patients recovered and 1 died.

Hemolytic anemia secondary to Mycoplasma pneumonia often occurs during 2 - 3 weeks of illness. Hemolysis is related to the high titer of cold agglutinin. Endovascular thrombosis can occur in some cases, and the majority of patients have a good prognosis, but death can occur in very severe cases.