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Treatment of Acute Cold Agglutinin Hemolytic Anemia With Transfusion of Adult i RBCs

Judith E. Woll, MD; Charles M. Smith, MD; Jacob Nusbacher, MD
JAMA. 1974;229(13):1779-1780. doi:10.1001/jama.1974.03230510053024.
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ACUTE cold agglutinin disease with severe hemolysis following primary atypical pneumonia was first described in 1943 by Horstmann and Tatlock.1 In a 1945 review of 200 cases of primary atypical pneumonia, 11 had hemolytic anemia of varying severity, which resulted in two deaths.2 Despite subsequent identification of the specificity of the cold autoantibody (anti-I), transfusion of such patients has been limited by the difficulty in obtaining compatible blood.

We report a patient with severe hemolysis associated with acute postinfectious cold agglutinin disease who was treated with transfusions of the rare, type i red blood cells (RBCs).

Report of a Case  A 51-year-old nulliparous white woman was admitted in October 1972 with a twoweek history of fever and cough, productive of yellow sputum, for which she took prescribed tetracycline for ten days. The fever remitted, but the cough persisted. Two days before admission, nausea and vomiting developed, and the


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