Fatal warm antibody autoimmune hemolysis with marked erythrocyte autoagglutination and liver necrosis

We have described a fatal case of autoimmune hemolysis associated with marked organ ischemia and lactic acidosis. Serologically the case was unusual because of the marked autoagglutination due to a warm antibody. Red cell agglutination at normal body temperature may have contributed to massive liver necrosis, lactic acidosis, and death.