Hemophagocytic lymphohistiocytosis associated with an IgG Cold agglutinin

Transfus Clin Biol. 2019 Nov;26(4):324-328. doi: 10.1016/j.tracli.2018.08.159. Epub 2018 Aug 25.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease eventually caused or reactivated by a viral infection, which can also lead to the production of cold agglutinins (CA). The nature of these autoantibodies is usually an IgM, less frequently an IgA or IgG, they agglutinate red blood cells at low temperatures. They can interfere with hematological parameters causing interpretation difficulties. We report a case of a 4-year-old boy who developed an IgG CA during recurrent HLH reactivated by EBV infection. The purpose of this observation is to underline HLH criteria and to analyze CA interference as well as its biological and clinical characteristics.

Keywords: Agglutinine froide; Anémie hémolytique; Cold agglutinins; Epstein-Barr virus; Hemolytic anemia; Hemophagocytic lymphohistiocytosis; IgG; Lymphohistiocytose hémophagocytaire.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anemia, Hemolytic, Autoimmune / complications*
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anti-Bacterial Agents / therapeutic use
  • Bone Marrow / pathology*
  • Child, Preschool
  • Cryoglobulins / analysis
  • Epstein-Barr Virus Infections / complications*
  • Humans
  • Immunoglobulin G / blood*
  • Lymphohistiocytosis, Hemophagocytic / blood
  • Lymphohistiocytosis, Hemophagocytic / complications*
  • Lymphohistiocytosis, Hemophagocytic / drug therapy
  • Lymphohistiocytosis, Hemophagocytic / pathology
  • Male
  • Recurrence
  • beta-Thalassemia / complications

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Cryoglobulins
  • Immunoglobulin G
  • cold agglutinins