Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report

Autoimmune hemolytic anemia (AIHA) is a rare hematologic disorder in the pediatric population and most cases are associated with microbiological infection. The pathological process is not completely clear, but some evidence suggests immunological dysregulation triggered by bacterial or viral infecti...

Full description

Bibliographic Details
Main Authors: Stefano Romano, Giuseppe Pepe, Ilaria Fotzi, Tommaso Casini, Elena Chiocca, Sandra Trapani
Format: Article
Language:English
Published: MDPI AG 2023-12-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/10/12/1895
Description
Summary:Autoimmune hemolytic anemia (AIHA) is a rare hematologic disorder in the pediatric population and most cases are associated with microbiological infection. The pathological process is not completely clear, but some evidence suggests immunological dysregulation triggered by bacterial or viral infections. Based on the thermal range of the pathogenic antibody, AIHA can be divided into warm (WAIHA) and cold (CAIHA) groups. <i>Cytomegalovirus</i> (CMV) is one of the most common viruses reported as a trigger of AIHA. We present an unusual case of AIHA in a 2-month-old infant positive for both the direct antiglobulin test (C3 complement fraction) and CMV–<i>Polymerase chain reaction</i> in blood samples. In this case, the dating of the infection was uncertain, making it impossible to discriminate between congenital flare-up or a primary acute episode, emphasizing the importance of CMV prenatal testing as a screening measure. We adopted multiple therapeutic strategies including steroids (methylprednisolone and prednisone), Intravenous Immunoglobulin, antivirals (ganciclovir and valganciclovir), and red blood cell transfusion.
ISSN:2227-9067