{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T08:07:18Z","timestamp":1779005238209,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":131,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Hematology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Mixed autoimmune hemolytic anemia (mAIHA) is a rare clinical condition where both warm and cold antibodies lead to autoimmune red cell destruction and progressive anemia. Herein, we report a rare case of combined warm and cold agglutinin\u2010mediated autoimmune hemolytic anemia in a 61\u2010year\u2010old male who initially presented with incidental macrocytic anemia during a preoperative evaluation for pterygium surgery. Investigations showed the presence of both warm (IgG) and cold (IgM) autoantibodies, evidenced by a positive direct Coombs test (both anti\u2010IgG and anti\u2010C3), and elevated serum IgM levels. Type and cross\u2010isolate revealed two distinct autoantibodies with different thermal amplitudes. Further workup did not reveal a definitive underlying etiology for the hemolysis. Mycoplasma pneumoniae and Epstein\u2013Barr virus antibody panels were not suggestive of active infection. He was treated with corticosteroids and rituximab, resulting in an improvement in his hemoglobin levels, a reduction in splenomegaly, and ultimately remission of his autoimmune hemolytic anemia. This case emphasizes the need for a thorough workup to identify the cause of anemia, even in the context of seemingly unrelated surgical procedures.<\/jats:p>","DOI":"10.1155\/crh\/8805562","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:30:38Z","timestamp":1778571038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Rare Presentation of Mixed Warm and Cold Autoimmune Hemolytic Anemia"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3819-8992","authenticated-orcid":false,"given":"Onyekachi","family":"Anya","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2613-1027","authenticated-orcid":false,"given":"Oluchi","family":"Idenyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9427-9059","authenticated-orcid":false,"given":"Ogbonna","family":"Chikere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9396-5976","authenticated-orcid":false,"given":"Joseph J.","family":"Shatzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_7_1_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12979-020-00208-7"},{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2007.08.002"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2016.1.690"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2027760"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024012585"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13730-024-00917-8"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2024-194219"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25084296"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra2033982"},{"key":"e_1_2_7_10_2","first-page":"90","article-title":"Cold AIHA and the Best Treatment Strategies","volume":"2022","author":"R\u00f6th A.","year":"2022","journal-title":"Hematology ASH Education Program"},{"key":"e_1_2_7_11_2","first-page":"1","article-title":"Eculizumab in Cold Agglutination Disease (DECADE) Trial and Case Series","volume":"2","author":"R\u00f6th A.","year":"2018","journal-title":"Blood Advances"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1217536"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-011-0065-3"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-5-156"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-232224"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000018984"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/1381861"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-023-04154-y"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/1744666x.2022.2089115"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/110245330601111466"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-025-05612-5"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18011"}],"container-title":["Case Reports in Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/8805562","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crh\/8805562","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/8805562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T07:30:35Z","timestamp":1779003035000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crh\/8805562"}},"subtitle":[],"editor":[{"given":"Andrew","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crh\/8805562"],"URL":"https:\/\/doi.org\/10.1155\/crh\/8805562","archive":["Portico"],"relation":{},"ISSN":["2090-6560","2090-6579"],"issn-type":[{"value":"2090-6560","type":"print"},{"value":"2090-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8805562"}}