Paroxysmal Cold Hemoglobinuria Associated With Monoclonal B-Cell Lymphocytosis in an Elderly Patient: A Report of a Rare Case
Year: 2025
Type: article
Study design: Case Report
Abstract: We report the case of an 86-year-old male with chronic anemia who presented with indirect hyperbilirubinemia, undetectable haptoglobin, and reticulocytosis. The peripheral smear showed no schistocytes. The cold-agglutinin titer was mildly positive, and the Donath-Landsteiner antibody test was positive. Bone marrow biopsy revealed a small CD5⁺ B-cell clone consistent with monoclonal B-cell lymphocytosis (MBL). The patient was diagnosed with paroxysmal cold hemoglobinuria (PCH) associated with MBL and treated with rituximab, achieving clinical stability without transfusion requirement. This case illustrates a rare coexistence of PCH and MBL in an elderly patient and emphasizes the importance of comprehensive hematologic evaluation for unexplained chronic hemolysis.
Source: Cureus
DOI: 10.7759/cureus.98102
Authors: Summiya Nasim, Matthew Bartock
Institution: Parkview Health
Language: English
Topic: Blood groups and transfusion
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7107953410