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...
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MDPI AG
2023-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/12/1895 |
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| author | Stefano Romano Giuseppe Pepe Ilaria Fotzi Tommaso Casini Elena Chiocca Sandra Trapani |
| author_facet | Stefano Romano Giuseppe Pepe Ilaria Fotzi Tommaso Casini Elena Chiocca Sandra Trapani |
| author_sort | Stefano Romano |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T20:54:08Z |
| format | Article |
| id | doaj.art-d0b58365d5e84066abde8a13366a1a85 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-08T20:54:08Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-d0b58365d5e84066abde8a13366a1a852023-12-22T14:00:25ZengMDPI AGChildren2227-90672023-12-011012189510.3390/children10121895Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case ReportStefano Romano0Giuseppe Pepe1Ilaria Fotzi2Tommaso Casini3Elena Chiocca4Sandra Trapani5Department of Health Science, University of Florence, 50134 Florence, ItalyDepartment of Health Science, University of Florence, 50134 Florence, ItalyCentre of Excellence, Division of Pediatric Oncology/Hematology, Meyer Children’s Hospital IRCCS, 50134 Florence, ItalyCentre of Excellence, Division of Pediatric Oncology/Hematology, Meyer Children’s Hospital IRCCS, 50134 Florence, ItalyCentre of Excellence, Division of Pediatric Oncology/Hematology, Meyer Children’s Hospital IRCCS, 50134 Florence, ItalyDepartment of Health Science, University of Florence, 50134 Florence, ItalyAutoimmune 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.https://www.mdpi.com/2227-9067/10/12/1895autoimmune hemolytic anemiacytomegaloviruschildren |
| spellingShingle | Stefano Romano Giuseppe Pepe Ilaria Fotzi Tommaso Casini Elena Chiocca Sandra Trapani Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report Children autoimmune hemolytic anemia cytomegalovirus children |
| title | Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report |
| title_full | Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report |
| title_fullStr | Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report |
| title_full_unstemmed | Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report |
| title_short | Autoimmune Hemolytic Anemia (AIHA) Secondary to <i>Cytomegalovirus</i> (CMV) Infection in a 2-Month-Old Infant: A Case Report |
| title_sort | autoimmune hemolytic anemia aiha secondary to i cytomegalovirus i cmv infection in a 2 month old infant a case report |
| topic | autoimmune hemolytic anemia cytomegalovirus children |
| url | https://www.mdpi.com/2227-9067/10/12/1895 |
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