AUTOHEMAGGLUTININS AND HEMOLYSINS WITH HEMOGLOBINURIA AND ACUTE HEMOLYTIC ANEMIA, IN AN ILLNESS RESEMBLING INFECTIOUS MONONUCLEOSIS

A case is reported of a young man with acute hemolytic anemia and hemoglobinuria who presented: an initial blood picture consistent with infectious mononucleosis, associated with a heterophile agglutination test positive in high dilution; auto-hemagglutinins, active in the cold, at room temperature and at 37 Centigrade; a hemolysin active at 37 C. after chilling, requiring the presence of a thermolabile component of serum for hemolysis; a positive Donath-Landsteiner test but no evidence of syphilis. In addition there was clubbing of the digits with certain other roentgenologic changes in the bones; absence of any other etiologic factors known to be concerned with such anemia; uneventful improvement under massive transfusion therapy, with apparent recovery from his hematologic disorder when studied two years later.