A case study of a child with chronic hemolytic anemia due to a Donath-Landsteiner positive, IgM anti-I autoantibody

Pediatr Blood Cancer. 2012 Nov;59(5):953-5. doi: 10.1002/pbc.24185. Epub 2012 May 2.


In children, paroxysmal cold hemoglobinuria (PCH) is generally considered an acute self-limited autoimmune hemolytic anemia caused by an IgG biphasic auto-anti-P antibody identified by the Donath-Landsteiner (D-L) test. We report a case of a 5-year-old female with a chronic hemolytic anemia. The etiology of the hemolysis appears to be an unusual D-L positive, IgM antibody with specificity for the I antigen. The clinical course is described and a discussion of PCH and the D-L antibody is presented. We also discuss intravenous immunoglobulin infusions as a therapy for children with this form of severe chronic autoimmune hemolytic anemia.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Hemolytic, Autoimmune / blood*
  • Anemia, Hemolytic, Autoimmune / drug therapy*
  • Autoantibodies / blood*
  • Child
  • Chronic Disease
  • Female
  • Humans
  • Immunoglobulin M*
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunologic Factors / administration & dosage*


  • Autoantibodies
  • Donath-Landsteiner antibody
  • Immunoglobulin M
  • Immunoglobulins, Intravenous
  • Immunologic Factors