Two cases of pediatric autoimmune hemolytic anemia

Abstract

Here, we report two rare pediatric cases of autoimmune hemolytic anemia (AIHA). Case 1 involved a 1-year-and-6-month-old boy who presented with pallor and lethargy two weeks following upper respiratory tract infection. Laboratory examination revealed severe anemia (hemoglobin level; 3.0 g/dL). Monospecific direct Coombs test result was positive for IgG antibodies, confirming the diagnosis of warm-type AIHA. The patient’s condition improved following pulse steroid therapy. Case 2 involved a 2-year-and-7-month-old boy who presented with fever and brown-colored urine (hemoglobin level; 9.0 g/dL, 4+ for occult blood in urine). Direct Coombs test result was positive for complement. The patient was diagnosed with cold paroxysmal hemoglobinuria. His condition improved with avoidance of cold exposure. Congenital hemolytic anemia, such as hereditary spherocytosis, is common in pediatric cases; thus, differentiating AIHA from these conditions is necessary. Furthermore, diagnosing a specific AIHA subtype is imperative because each subtype warrants a different treatment approach.