{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:55:09Z","timestamp":1777694109360,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Mycoplasma pneumoniae infection commonly causes mild respiratory illness, but cold agglutinin syndrome (CAS) is an uncommon extrapulmonary complication. CAS typically results in mild, predominantly extravascular hemolysis; however, severe intravascular hemolysis and acute kidney injury (AKI) are rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 59-year-old woman presented with profound weakness, jaundice, dark urine, and anuria following a mild upper respiratory illness. Laboratory evaluation revealed severe intravascular hemolysis, markedly elevated LDH activity, undetectable hemoglobin (Hb) level, hemoglobinuria, and AKI. Direct antiglobulin testing was positive for C3d only, and the cold agglutinin titer was markedly elevated (1:2048). Mycoplasma pneumoniae IgM serology was positive. She required warmed blood transfusions, antibiotics, thermal protection, and continuous renal replacement therapy. Over 10\u2009days, hemolysis-related laboratory parameters and serum creatinine level improved significantly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case illustrates a rare and severe form of Mycoplasma pneumoniae-associated CAS presenting with massive intravascular hemolysis and AKI. Early recognition and supportive interventions\u2014particularly warmed transfusions and renal support\u2014were critical to recovery. Clinicians should consider cold agglutinin-mediated hemolysis in patients with dark urine and AKI following respiratory infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795476261426064","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T04:43:02Z","timestamp":1773895382000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Intravascular Hemolysis and Acute Kidney Injury Triggered by Mycoplasma-Associated Cold Agglutinin Disease: A Case Report"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2369-7494","authenticated-orcid":false,"given":"Ziad W.","family":"Elmezayen","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Kafr Elsheikh University, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0386-6742","authenticated-orcid":false,"given":"Mohammad","family":"Adi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702009000100018"},{"key":"e_1_3_3_3_2","first-page":"46","article-title":"Cold agglutinin syndrome secondary to Mycoplasma pneumoniae","volume":"4","author":"Kazi BS","year":"2024","unstructured":"Kazi BS, Maurya A, Chakrapani A, Rumani I. Cold agglutinin syndrome secondary to Mycoplasma pneumoniae. J Hematol Allied Sci. 2024;4:46-47.","journal-title":"J Hematol Allied Sci"},{"issue":"3","key":"e_1_3_3_4_2","first-page":"255","article-title":"Severe intravascular hemolysis and acute kidney injury associated with cold agglutinin disease","volume":"45","author":"bFalk M","year":"2020","unstructured":"bFalk M, Johnson R, Peterson A. Severe intravascular hemolysis and acute kidney injury associated with cold agglutinin disease. J Hematol Ren Dis. 2020;45(3):255-262.","journal-title":"J Hematol Ren Dis"},{"issue":"4","key":"e_1_3_3_5_2","first-page":"180","article-title":"Cold agglutinin disease: pathophysiology and renal involvement in Mycoplasma pneumoniae infection","volume":"28","author":"Michalopoulos D","year":"2019","unstructured":"Michalopoulos D, Spyridopoulos I, Daskalakis M. Cold agglutinin disease: pathophysiology and renal involvement in Mycoplasma pneumoniae infection. Clin Nephrol Rev. 2019;28(4):180-185.","journal-title":"Clin Nephrol Rev"},{"issue":"5","key":"e_1_3_3_6_2","first-page":"389","article-title":"Cold agglutinin disease and its association with Mycoplasma pneumoniae infection","volume":"35","author":"Stojanovic J","year":"2018","unstructured":"Stojanovic J, Martinovi\u0107 Z, Bo\u017ei\u0107 M. Cold agglutinin disease and its association with Mycoplasma pneumoniae infection. Infect Dis Med. 2018;35(5):389-395.","journal-title":"Infect Dis Med"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.08.201"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000478991"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.70010"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2016.1.226"}],"container-title":["Clinical Medicine Insights: Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795476261426064","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795476261426064","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795476261426064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:14:28Z","timestamp":1777454068000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795476261426064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":9,"alternative-id":["10.1177\/11795476261426064"],"URL":"https:\/\/doi.org\/10.1177\/11795476261426064","relation":{},"ISSN":["1179-5476","1179-5476"],"issn-type":[{"value":"1179-5476","type":"print"},{"value":"1179-5476","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"article-number":"11795476261426064"}}