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[Paroxysmal cold hemoglobinuria in a 2-year-old boy].
B Bohnhorst1, F Krull, P F Hoyer
1Abteilung Kinderheilkunde II, Kinderklinik der Medizinischen Hochschule, Hannover.
Summary
A two-year-old boy experienced severe abdominal pain and blood in his urine due to cold-induced hemolytic anemia. This condition was caused by a specific autoantibody, which later disappeared, leading to a full recovery.
Area of Science:
- Pediatric Medicine
- Immunology
- Hematology
Background:
- Cold agglutinin disease is a rare autoimmune hemolytic anemia.
- Donath-Landsteiner antibodies are specific autoantibodies that cause paroxysmal cold hemoglobinuria.
Observation:
- A two-year-old boy presented with recurrent episodes of severe abdominal pain and macrohematuria.
- Symptoms occurred after exposure to very low temperatures.
Findings:
- The patient was diagnosed with acute hemolytic anemia and hemoglobinuria.
- The condition was triggered by a cold-reacting Donath-Landsteiner autoantibody.
- Hemolysis parameters normalized within days, and hemoglobin levels returned to normal in 4 weeks.
Implications:
- This case highlights the importance of considering cold agglutinin disease in children with unexplained hemolytic anemia and hemoglobinuria.
- The transient nature of the Donath-Landsteiner autoantibody suggests a potential for complete recovery.
- Early diagnosis and management are crucial for favorable outcomes in pediatric cold agglutinin disease.