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

Aseem Kumar Tiwari; Geet Aggarwal; Subhasis Mitra; Dinesh Arora; Gunjan Bhardwaj; Ankita Ratan; Divya Setya

doi:10.4103/ajts.AJTS_132_17

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

Asian J Transfus Sci. 2020 Jan-Jun;14(1):57-59. doi: 10.4103/ajts.AJTS_132_17. Epub 2020 Jul 24.

Authors

Aseem Kumar Tiwari¹, Geet Aggarwal¹, Subhasis Mitra¹, Dinesh Arora¹, Gunjan Bhardwaj¹, Ankita Ratan¹, Divya Setya¹

Affiliation

¹ Department of Transfusion Medicine, Medanta-The Medicity, Gurgaon, Haryana, India.

Abstract

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.

Keywords: Autoimmune hemolytic anemia; Donath–Landsteiner test; paroxysmal cold hemoglobinuria.

Publication types

Case Reports