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A Case of Autohemolytic Anemia Complicated to Viral Pneumonia

Journal of the Korean Pediatric Society 1966;9(5):303-308.
Published online September 30, 1966.
A Case of Autohemolytic Anemia Complicated to Viral Pneumonia
Koo Chang Chung1, Young Zu Cho1, Tai Hee Kwon1, Dong Shlk Chin1, Duk Yong Kang2
1Department of Pediatrics,College of Medicine, Ewha Womans University
2Department of Clinical Pathology,College of Medicine,Ewha Womans University
原發性肺炎에 㻂發된自己免疫性落血性貧血의 症例
鄭求昌1, 趙英珠1, 權泰喜1, 陳東植1, 姜得龍2
1製花女子大學校 醫科大學 小兒科學敎室
2梨花女子大學校醫科大學 臨床病理敎室
Abstract
A one year-old female infant of autohemolytic anemia during the course of viral pneumonia is presented. Acute respiratory symptoms and signs were begining on Nov.-16, 1964 and followed by active hemolytic episode one month later; such as anemia with extremely low level of hemoglobin, jaundice with moderately elevated direct and indirect bilirubin levels in serum, increased urobilinogen amount in urine and feces, marked reticulocytosis, hepatosplenomegaly and positive Coombs test. Direct Coombs test revealed strongly positive reaction without the presense of prozone phenome-non, but by means of the indirect Coombs test, incomplete antibodies (so-called autoantibodies) were 1 also more active in only lower dilution at 20° C than at 37° C, same pattern in acidified patient’s serum at 20° C, these are indicated the presense of incomplete antibodies of the cold agglutinin type. Further more, antibody studies with O CDe/cDE test cells also revealed that the agglutination: between the patient's serum and the known red cell of group O blood was more active at a temperature of 4°C, then more at 20° C than at 37° C. The patient has been placed on the treatment of adequate blood transfusion, which was more. frequently needed initialy, then total more than 10 times during 12 months until,last blood transfusion was performed on Dec. -15, 1965, and prolonged oral use of prednisolone 15mg per day. Subsequently no hemolytic evidences are found up to the present, June 30, 1966. At the present, moderate hepatomegaly, frequent cough with U.R.I. and under nourished status are still troublesome for the patient. Further close observation, therefore, may be needed for a long time.


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