ABSTRACT
Paroxysmal cold hemoglobinuria is a type of hemolytic anemia that mainly affects children. Tubular renal injury induced by the heme pigment in intravascular hemolysis is a rare cause of renal failure. We describe the case of a 5-year-old boy who presented with dehydration and dark urine a few hours after exposure to cold. The child had had an upper respiratory infection the previous week. He developed anemia and acute renal failure. The direct antiglobulin test was positive with anti-C3c and C3d. The diagnosis of paroxysmal cold hemoglobinuria was confirmed by the presence of biphasic antibody in the Donath-Landsteiner test.
Subject(s)
Acute Kidney Injury/etiology , Hemoglobinuria, Paroxysmal/complications , Child, Preschool , Hemoglobinuria, Paroxysmal/diagnosis , Humans , MaleABSTRACT
La hemoglobinuria paroxística al frío es una forma de anemia hemolítica que afecta principalmente a niños. La toxicidad tubular renal del pigmento hemo en situaciones de hemólisis intravascular constituye una etiología rara de insuficiencia renal. Se presenta el caso de un paciente de 5 años que presenta deshidratación y orina oscura horas después de exponerse al frío. Una semana antes había un antecedente de infección de las vías aéreas superiores. En su evolución desarrolla anemia e insuficiencia renal aguda. El test de Coombs directo es positivo con anti-C3c y C3d. La presencia de anticuerpos bifásicos queda demostrada con la prueba de Donath-Landsteiner, lo que confirma el diagnóstico de hemoglobinuria paroxística al frío
Paroxysmal cold hemoglobinuria is a type of hemolytic anemia that mainly affects children. Tubular renal injury induced by the heme pigment in intravascular hemolysis is a rare cause of renal failure. We describe the case of a 5-year-old boy who presented with dehydration and dark urine a few hours after exposure to cold. The child had had an upper respiratory infection the previous week. He developed anemia and acute renal failure. The direct antiglobulin test was positive with anti-C3c and C3d. The diagnosis of paroxysmal cold hemoglobinuria was confirmed by the presence of biphasic antibody in the Donath-Landsteiner test
