• Pediatric Infection and Vaccine
• /
• v.5 no.2
• /
• pp.302-307
• /
• 1998

Hemolytic anemia due to cold agglutinin disease is a known complication of Mycoplasma pneumoniae infection but is rarely observed, particularly in children. A case of Mycoplasma pneumonia complicated with hemolytic anemia is presented. A 7 year-old girl was adimitted because of fever, cough, sputum and pale appearance. Chest X-ray showed pneumonic consolidation of Rt. upper lobe, lingular division. Laboratory studies disclosed the following values : Hb 5.3g/dL, Hct 11.1%, reticulocyte 2.9%, indirect Coombs test negative, direct Coombs test(monovalent) Anti-C3d positive, Anti-IgG negative, Anti-IgM negative, cold agglutinin titer 1 : 256, mycoplasma antibody titer 1 : 640, total bilirubin 1.0mg/dL. Initial PBS before wanning showed agglutination of red blood cells. The diagnosis of cold agglutinin hemolytic anemia complicating mycoplasma pneumonia was made. And treatment with roxithromycin, prednisolone and avoiding cold exposure was initiated, and complete recovery ensued. We report a case of cold agglutinin hemolytic anemia complicating mycoplasma pneumonia in children.

• Clinical and Experimental Pediatrics
• /
• v.50 no.6
• /
• pp.511-518
• /
• 2007

To understand the hemolytic anemia (HA) in children, the diagnostic approach and management of hereditary and acquired HA are described. The hereditary hemolytic anemia (HHA) can be classified according to the pathogenesis into three types : RBC membrane defects, hemoglobinopathies, and RBC enzymopathies. Clinical characteristics, laboratory findings and molecular defects of these three types are presented briefly. In Korea, HHA due to the RBC membrane defect, hereditary spherocytosis had been reported often but HHA due to hemoglobinopathies and RBC enzymopathies had been thought to be relatively rare. With recent development in the molecular diagnosis, ${\beta}$ thalassemia, mostly heterozygote, G6PD and pyruvate kinase deficiency have been reported with gene characterization. If the patients with microcytic hypochromic anemia show unproportionally low MCV or MCH or refractory to the iron therapy, hemoglobin electrophoresis and gene analysis for thalassemia or other unstable hemoglobinopathies need to be done accordingly. The global movement of the population especially from the region prevalent of hemoglobinopathies or enzymopathies to Korea warrants considering broad spectrum of etiology for the diagnosis of HHA. Aquired HA resulting from extracellular factors such as autoimmune HA from warm antibody, cold agglutinin and paroxysmal cold hemoglobinuria as well as nonimmune HA are described briefly.

• Pediatric Infection and Vaccine
• /
• v.16 no.2
• /
• pp.215-219
• /
• 2009

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in children, with a peak incidence at 5-14 years. Extrapulmonary manifestations occur in 20-25% of patients with M. pneumoniae infection. Most auto-antibodies that cause immune hemolytic anemia in humans are cold agglutinins. The formation of cold agglutinins is frequently observed during M. pneumoniae infections, and cold agglutinin disease usually occurs during M. pneumoniae infections. Nevertheless, severe hemolysis is exceptional. If a patient has any underlying disease related to hemolysis, it is possible to accelerate hemolysis. Hereditary spherocytosis is a common cause of hereditary hemolytic anemia resulting from red blood cell membrane defects. Hemolysis of red cells may result from corpuscular abnormalities or extracorpuscular abnormalities, such as immune or non-immune mechanisms. We report a case of hereditary spherocytosis associated with severe hemolytic anemia due to Mycoplasma pneumonia.

• Tuberculosis and Respiratory Diseases
• /
• v.39 no.2
• /
• pp.194-198
• /
• 1992

Mycoplasma pneumoniae produces illness in man ranging from mild upper respiratory tract infection to severe bronchitis and pneumonia. We experienced a case of mycoplasma pneumonia complicated with acute respiratory failure, cold agglutinin hemolytic anemia, pleural effusion, Raynaud's phenominon and hepatitis in 27-year-old female. She was diagnosed as having mycoplasma pneumonia by detecting mycoplasma antibody and cold agglutinin test and treated effectively with erythromycin.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.3
• /
• pp.636-642
• /
• 1998

The frequency of fulminant peumonia due to Mycoplasma pneumoniae is relatively rare despite the high prevalence of Mycoplasma species infection in the general population. We report a case of mycoplasma pneumonia complicated with severe ARDS, overt hemolytic anemia and hepatitis. He had high titers of antimycoplasma antibody and cold agglutinin. Despite erythromycin administration, the pneumonic infiltration on chest radiography was not resolved, and mechanical ventilation was needed for 16 days. During the therapeutic course, his hemoglobin decreased. After the administration of prednisolone, his hemoglobin increased and pneumonic infiltration was totally resolved. He had a progressively favorable course and could be discharged in relatively good clinical condition.