ABSTRACT
We report a case of cold hemagglutinin disease associated with Mycoplasma pneumoniae infection treated with cord blood transfusion. Cold hemagglutinin disease is a hemolytic anemia most commonly associated with cold-reactive autoantibody with anti-I specificity. On the basis of the fact that the level of I antigen on cord red blood cells is extremely low, a six year old male patient was transfused with 60 mL of ABO blood type-matched, cord blood. No complication from the transfusion was observed. Due to the deficiency in cord blood supply, filtered irradiated RBC 100 mL was transfused three times thereafter. The hemoglobin level began to increase from the fifth hospital day. The patient was discharged without additional transfusion on the eleventh hospital day. No remarkable complications were noted at the time of discharge.
Subject(s)
Humans , Male , Anemia, Hemolytic , Erythrocytes , Fetal Blood , Hemagglutinins , Mycoplasma pneumoniae , Pneumonia, Mycoplasma , Sensitivity and SpecificityABSTRACT
Cerebral malalria is a life-threatening complication of Plasmodium falciparum infection. RBC exchange transfusion (RCE) can reduce the burden of parasitemia in this situation. We have experienced two cases of cerebral malaria treated with automated RBC exchange as an adjunct to standard chemotherapy. Case 1: A 42-year-old male was referred to the emergency room with a history of 3 days of fever after having returned from Congo. Peripheral blood smear showed the P. falciparum parasitemia of 70-80%. Quinidine and doxycycline were administered but, mental state started to deteriorate. He underwent RCE on hospital day 2 to reduce the parasitemia to 10% after 8 hours. No parasite could be found on day 3 after the RCE. Case 2: A 62-year-old male was referred to the emergency room with a history of 3 days of fever after having returned from Cameroon. P. falciparum parasitemia was 10% on peripheral blood smear. Quinidine and doxycycline were immediately started but headache developed abruptly and he underwent RCE on hospital day 3. After 8 hours following the completion of RCE, parasitemia decreased to less than 1%. Automated RBC exchange transfusion can rapidly reduce the burden of parasitemia and achieve improvement of neurologic symptom and sign in patients with cerebral malaria.