{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:10:08Z","timestamp":1756361408622,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,10,15]]},"abstract":"<jats:p>Donath-Landsteiner haemolytic anaemia (DLHA), also known as paroxysmal cold haemoglobinuria, is a very rare and difficult condition to diagnose as well as treat. Here, we present a case of a 55-year-old Hispanic woman who presented with severe intravascular haemolytic anaemia in the setting of a viral illness 2\u2009weeks prior to presentation. Direct antiglobulin testing revealed mixed results: positive for either complement, IgG or both on various occasions which led to a battery of tests including the Donath-Landsteiner antibody testing which turned out positive establishing the diagnosis of DLHA. She was initially treated unsuccessfully with supportive care in the form of packed red blood cell transfusions and steroids as well as rituximab for about 4\u2009weeks but her condition improved on cyclophosphamide, and she is on the road to recovery after 10 weeks of hospital stay.<\/jats:p>","DOI":"10.1136\/bcr-2018-226475","type":"journal-article","created":{"date-parts":[[2018,11,9]],"date-time":"2018-11-09T02:25:33Z","timestamp":1541730333000},"page":"bcr-2018-226475","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Case of Donath-Landsteiner haemolytic anaemia in an adult female"],"prefix":"10.1136","volume":"2018","author":[{"given":"Ruchi","family":"Bhatt","sequence":"first","affiliation":[{"name":"Medicine, Nassau University Medical Center, East Meadow, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Calvo","sequence":"additional","affiliation":[{"name":"Medicine, Nassau University Medical Center, East Meadow, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gagan","family":"Raju","sequence":"additional","affiliation":[{"name":"Medicine, Nassau University Medical Center, East Meadow, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alida","family":"Podrumar","sequence":"additional","affiliation":[{"name":"Medicine, Nassau University Medical Center, East Meadow, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,11,8]]},"reference":[{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/trf.13888","article-title":"Paroxysmal cold hemoglobinuria: a difficult diagnosis in adult patients","volume":"57","author":"Zeller","year":"2017","journal-title":"Transfusion"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.2","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/ped.12110","article-title":"Paroxysmal cold hemoglobinuria caused by an IgM-class Donath-Landsteiner antibody","volume":"55","author":"Hayashi","year":"2013","journal-title":"Pediatr Int"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.3","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1159\/000438964","article-title":"Role of Complement in Autoimmune Hemolytic Anemia","volume":"42","author":"Berentsen","year":"2015","journal-title":"Transfus Med Hemother"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.4","first-page":"20","article-title":"Paroxysmal cold hemoglobinuria in an elderly patient: A rare case with poor prognosis","volume":"2","author":"Patel","year":"2016","journal-title":"J Case Rep Images Med"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.5","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.hoc.2015.01.004","article-title":"Paroxysmal cold hemoglobinuria","volume":"29","author":"Shanbhag","year":"2015","journal-title":"Hematol Oncol Clin North Am"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.6","doi-asserted-by":"publisher","DOI":"10.3109\/10408367809150915"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.7","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1111\/j.1537-2995.2007.01414.x","article-title":"Rituximab as successful therapy in a patient with refractory paroxysmal cold hemoglobinuria","volume":"47","author":"Koppel","year":"2007","journal-title":"Transfusion"},{"key":"2025082722405307000_2018.nov08_1.bcr-2018-226475.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-010-1123-x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226475","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:41:03Z","timestamp":1756359663000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226475"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,8]]},"references-count":8,"alternative-id":["10.1136\/bcr-2018-226475"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226475","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,11,8]]}}}