Year: 2026
Type: article
Study design: Case Report
Abstract: CaseAn 82-year-old woman with a history of cold-agglutinin hemolytic anemia was admitted with nausea and diarrhea due to infectious gastroenteritis.Her course was complicated by pneumonia.Blood culture and respiratory virus PCR panel were negative.No lymphadenopathy or splenomegaly was identified.Laboratory studies revealed hemoglobin 10.2 g/dL, bilirubin 5.9 mg/dL, LDH 889 U/L, and haptoglobin 2 mg/dL.DAT was positive for IgG (very weak + ) and C3 (weak 1 + ), cold-agglutinin test showed a high-titer to adult red cells (1:10,240), and cold-autoantibody with "I" specificity.Serology for anti-Mycoplasma-pneumoniae IgM was negative.Peripheral blood smear demonstrated red cell agglutination (Figure 1A ; 20x objective, Wright-Giemsa-stain), monocytosis (40%) with striking erythrophagocytosis by monocytes (Figure 1A , insets; 100x objective), and platelet clumping.Flow cytometry revealed a small kappa-restricted B-cell population (0.4%), which was CD5(partial dim + ), CD10(-), CD19( + ), CD20( + ), CD22( + ), CD23( -), CD103( -), CD25( -)CD38( + ) (Figure 1B-D ).Monocytes showed normal immunophenotype.IFE detected a faint IgM-kappa monoclonal gammopathy (Figure 1E , asterisks).The patient declined any additional evaluation or intervention and was discharged to hospice care.
Source: eJHaem
DOI: 10.1002/jha2.70439
Institutions: Duke Medical Center, Duke Cancer Institute
Language: English
Topic: Blood groups and transfusion
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,860
OpenAlex ID: W7223142114