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Case report: paroxysmal cold hemoglobinuria presenting during pregnancy.

Andrea O Akpoguma1, Thomas L Carlisle1, Steven R Lentz1

  • 1Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA USA.

BMC Hematology
|February 21, 2015
PubMed
Summary

Paroxysmal cold hemoglobinuria, a rare condition, was diagnosed in a pregnant patient. This case highlights the successful management and positive pregnancy outcome, with no neonatal complications.

Keywords:
Donath-Landsteiner antibodyHemolytic anemiaParoxysmal cold hemoglobinuriaPregnancy

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Area of Science:

  • Hematology
  • Immunology
  • Obstetrics

Background:

  • Paroxysmal cold hemoglobinuria (PCH) is an autoimmune hemolytic anemia.
  • It is triggered by biphasic IgG autoantibodies and complement activation.
  • PCH has not been previously documented during pregnancy.

Purpose of the Study:

  • To report the first case of PCH presenting during pregnancy.
  • To describe the clinical course and management of PCH in a pregnant patient.
  • To emphasize the successful pregnancy outcome.

Main Methods:

  • Case report of an 18-year-old female in early pregnancy.
  • Diagnosis confirmed by positive Donath-Landsteiner antibody test.
  • Supportive treatment and close maternal-fetal monitoring.

Main Results:

  • Acute hemolytic anemia resolved within 6 weeks.
  • Successful pregnancy with no evidence of neonatal anemia or hemolysis.
  • Maternal autoantibodies did not affect the fetus.

Conclusions:

  • This case represents the first reported instance of PCH during pregnancy.
  • Supportive management can lead to a successful pregnancy outcome.
  • Close monitoring is crucial due to the potential for maternal autoantibodies to affect the fetus.