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KMID : 0367419660090050017
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Journal of Korean Pediatric Society
1966 Volume.9 No. 5 p.17 ~ p.22
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A Case of Autohemolytic Anemia Complicated to Viral Pneumonia
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鄭求昌/Chung, Koo Chang
趙英珠/權泰喜/陳東植/姜得龍/Cho, Young Zu/Kwon, Tai Hee/Chin, Dong Shik/Kang, Duk Yong
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Abstract
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A one year-old female infant of autohemolytic anemia during the course of viral pneumonia is presented.
Acute respiratory symptoms and signs were begining on Nov.-16, 1964 and followed by active hemolytic episode one month later; such as anemia with extremely low level of hemoglobin, jaundice with moderately elevated direct and indirect bilirubin levels in serum, increased urobilinogen amount in urine and feces, marked reticulocytosis, hepatosplenomegaly and positive Coombs test.
Direct Coombs test revealed strongly positive reaction without the presense of prozone phenomenon, but by means of the indirect Coombs test, incomplete antibodies (so-called autoantibodies) were also more active in only lower dilution at 20C than at 37 C, same pattern in acidified patient´s serum at 20C, these are indicated the presence of incomplete antibodies of the cold agglutinin type.
Further more, antibody studies with O CDe/cDE test cells also revealed that the agglutination between the patient´s serum and the known red cell of group O blood was more active at a temperature of VC, then more at 20C than at 37 C.
The patient has been placed on the treatment of adequate blood transfusion, which was more frequently needed initialy, then total more than 10 times during 12 months until last blood transfusion was performed on Dec. -i5, 1965, and prolonged oral use of prednisolone 15mg per day. Subsequently no hemolytic evidences are found up to the present, June 30, 1966.
At the present, moderate hepatomegaly, frequent cough with U.R.I. and under nourished status are still troublesome for the patient.
Further close observation, therefore, may be needed for a long time.
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