Abstract
Autoimmune hemolytic anemia is relatively rare and cold autoimmune hemolytic anemia is even more uncommon. Herein, we describe a 3 -year-old boy with cold agglutinin disease secondary to mycoplasma infection. He was admitted to another hospital with status epilepticus accompanied by fever. On admission, anemia, macroscopic hematuria and renal dysfunction were identified and the patient was transferred to our pediatric intensive care unit. Additional tests detected elevated deviation enzymes, elevated serum bilirubin, decreased haptoglobin and complement, and hemoglobinuria indicating hemolytic anemia. The direct Coombs test was positive for C3d and negative for IgG, indicating cold autoimmune hemolytic anemia. However, an elevated cold agglutinin titer of 512 and negative Donath-Landsteiner findings excluded paroxysmal cold hemoglobinuria and indicated cold agglutinin disease. Furthermore, the LAMP test revealed mycoplasma infection, which can precede cold agglutinin disease. Cold agglutinin disease secondary to mycoplasma infection typically recovers spontaneously within several weeks. This patient recovered without specific therapy except for a single transfusion of red blood cells and maintaining warmth.
