Applying Donath-Landsteiner test for the diagnosis of paroxysmal cold hemoglobinuria

61-year old male patient was admitted to the hospital with clinical picture of hemolytic anemia with hemoglobinuria. Patient was suspected to have Infectious Mononucleosis (IM) with Auto Immune Hemolytic Anemia (AIHA). DAT was positive with anti-C3d specificity. Donath Landsteiner (DL) test was posi...

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Published inAsian journal of transfusion science Vol. 14; no. 1; pp. 57 - 59
Main Authors Tiwari, Aseem, Aggarwal, Geet, Mitra, Subhasis, Arora, Dinesh, Bhardwaj, Gunjan, Ratan, Ankita, Setya, Divya
Format Journal Article
LanguageEnglish
Published Ahmedabad Wolters Kluwer India Pvt. Ltd 01.01.2020
Medknow Publications and Media Pvt. Ltd
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer - Medknow
Wolters Kluwer Medknow Publications
Subjects
Anemia
Antibodies
Autoimmune diseases
autoimmune hemolytic anemia
Autoimmunity
Case Report
Case reports
Cold
Diagnostic tests
donath–landsteiner test
Hemoglobin
Medical diagnosis
paroxysmal cold hemoglobinuria
Donath-Landsteiner test
paroxysmal cold hemoglobinuria
Autoimmune hemolytic anemia
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Summary:61-year old male patient was admitted to the hospital with clinical picture of hemolytic anemia with hemoglobinuria. Patient was suspected to have Infectious Mononucleosis (IM) with Auto Immune Hemolytic Anemia (AIHA). DAT was positive with anti-C3d specificity. Donath Landsteiner (DL) test was positive; confirming Paroxysmal Cold Hemoglobinuria (PCH). The final diagnosis was IM with PCH. Patient was managed conservatively and discharged after seven days. DL test specifically detects a biphasic autoantibody (IgG type) that binds to RBCs at cold temperatures, and fixes complement on the RBC membrane. However RBCs are only lysed upon warming to 37C when complement cascade proceeds to completion.
ISSN:0973-6247
1998-3565
DOI:10.4103/ajts.AJTS_132_17