HEMOLYTIC ANEMIA COMPLICATING PRIMARY ATYPICAL PNEUMONIA WITH COLD ISOHEMAGGLUTININS

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Abstract
A review of the literature indicates that hemolytic anemia has complicated primary atypical pneumonia in 5% of a series of 200 cases observed by one writer. Though this complication usually develops at a time when the maximal titer of cold agglutinins is present in the blood, it may not develop in the presence of equally high titers of cold agglutinins. The administration of a sulfonamide compound has been considered a contributory cause of the hemolytic crisis in such cases, by some authors. A case history of a 68 yr. old mother is reported. This patient developed a severe hemolytic crisis during an episode of primary atypical pneumonia. Cold isohemagglutinins developed to a titer of 1:2048 at icebox and room temps. A transfusion of blood was complicated by the presence of RH incompatibility. The patient made an excellent recovery. Two months following the appearance of the hemolytic crisis, a blood cold isohemagglutinin determination was positive to a dilution of 1: 512 at 5[degree]C, and negative at a room temp. of 20 [degree]C.

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