Cmv & aiha

[John C. Staley]

Has any one heard of an Autoimmune Hemolytic Anemia secondary to CMV? We've had a patient that the University Hospital indicated had a primary CMV infection and AHA. I've never heard of CMV resulting in AHA but then I'm pretty sure I've not heard of everything. I'm old but not that old.

[PamD]

We had a three month old who had never been transfused that presented with a Hgb of 3, DAT 4+, antibody screen reacted with all cells 4+. First panel: all cells reacted 4+. Second panel had one cell that was negative. That cell was also neg for S and s. Selected cells that were S and s neg were all negative. All units crossmatched were incompatible. Even though the baby was of Asian decent, we called it as warm auto with Anti-U specificity. S neg, s neg units were obtained from the blood center and crossmatched just fine. The hematologist told us he belived the antibody was secondary to active CMV infection obtained by nursing from mother with active CMV infection. When the infant's CMV infection subsided, so did the antibody. At a follow up visit in our hematology clinic when the infant was 7 months of age, we obtained blood and typed the infant as S pos/s pos. That's my one and only experience with a warm auto resulting from CMV infection.

[David Saikin]

Viral sequelae can take many forms . . . why not AIHA?

[Malcolm Needs ☆]

I agree with David.

One only has to think of the "normal" presentation of a case of PCH in a child following a viral infection.

[John C. Staley]

I failed to mention that this was a young man in his mid 20s. I have no idea what his pretransfusion work up looked like.

I have to think that he was immune compromised to some degree for the CMV to be as virulent as it appears to have been.

My thoughts had been along the same line as David's it's just that this was a new twist from past experiences.

It's times like this I kinda miss the big world.

:eyepoppin

[NedB]

PamD: Did you perchance test the mother for this antibody?