Autoimmune hemolytic anemia due to biphasic Donath-Landsteiner hemolysin: a diagnostic challenge

Autoimmune hemolytic anemia due to Donath-Landsteiner biphasic hemolysin represents a real diagnostic challenge due to its low frequency and the complex methodology involved in the test used to confirm it. It usually presents abruptly in previously healthy children, secondary to a viral infection. The symptoms derived from the intense intravascular hemolysis are often confused with sepsis. Although its evolution is self-limited and has a good prognosis, it usually causes prolonged hospitalization with potential morbidity due to the performance of complementary tests and unnecessary treatments. The case of a child diagnosed with autoimmune hemolytic anemia secondary to biphasic hemolysin is presented to highlight the importance of timely diagnosis for adequate treatment.