{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:28:41Z","timestamp":1790270921609,"version":"4.1.0"},"reference-count":79,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T00:00:00Z","timestamp":1739577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian ministry of health","doi-asserted-by":"publisher","award":["ricerca corrente"],"award-info":[{"award-number":["ricerca corrente"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In Epstein\u2013Barr virus infectious mononucleosis, hemolytic anemia occasionally occurs. Methods: To characterize hemolytic anemia linked to Epstein\u2013Barr virus infectious mononucleosis, we performed a systematic review (PROSPERO CRD42024597183) in the United States National Library of Medicine, Excerpta Medica, and Web of Science with no restrictions on language. Only reports published since 1970 were included. Eligible were reports describing hemolytic anemia in subjects with clinical signs and microbiological markers of Epstein\u2013Barr virus mononucleosis. Results: In the literature, we detected 56 reports released between 1973 and 2024, documenting 60 individuals (32 females and 28 males; 27 children and 33 adults) with hemolytic anemia linked to Epstein\u2013Barr virus infectious mononucleosis. The mechanism underlying anemia was categorized as cold-antibody-mediated (N = 31; 52%), warm-antibody-mediated (N = 18, 30%), mixed warm- and cold-antibody-mediated (N = 4; 6.7%), or paroxysmal cold hemoglobinuria (N = 2; 3.3%). The remaining 5 cases (8.3%) remained unclassified. Observation alone was the chosen approach in 23% of cases (N = 14). Steroids (67%; N = 40) and blood transfusions (38%; N = 23) were the most commonly used treatment, while plasma exchange, intravenous polyclonal immunoglobulin, rituximab, and splenectomy were used less frequently. Observation was slightly but significantly (p = 0.032) more common in cases of cold-antibody-mediated anemia compared to all other cases combined. Patients recovered a median of 28 [interquartile range 21\u201339] days after disease onset. Two patients with warm-antibody-mediated hemolytic anemia died. Conclusions: This literature review points out that Epstein\u2013Barr virus, like Mycoplasma pneumoniae, cytomegalovirus, or severe acute respiratory syndrome coronavirus 2, may act as a trigger for immune-mediated hemolytic anemia.<\/jats:p>","DOI":"10.3390\/jcm14041283","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T03:41:47Z","timestamp":1739763707000},"page":"1283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hemolytic Anemia Linked to Epstein\u2013Barr Virus Infectious Mononucleosis: A Systematic Review of the Literature"],"prefix":"10.3390","volume":"14","author":[{"given":"Dario F.","family":"Meloni","sequence":"first","affiliation":[{"name":"Family Medicine, Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana, 6900 Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro B.","family":"Far\u00e9","sequence":"additional","affiliation":[{"name":"Family Medicine, Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana, 6900 Lugano, Switzerland"},{"name":"Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3829-4254","authenticated-orcid":false,"given":"Gregorio P.","family":"Milani","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Universit\u00e0 Degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8391-5462","authenticated-orcid":false,"given":"Sebastiano A. G.","family":"Lava","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario G.","family":"Bianchetti","sequence":"additional","affiliation":[{"name":"Family Medicine, Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana, 6900 Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuele","family":"Renzi","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, CHUL-Laval, Quebec City, QC G1V 0A6, Canada"},{"name":"Department of Pediatrics, Laval University, Quebec City, QC G1V 4G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Bertacchi","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Unit, Geneva University Hospitals, 1206 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Kottanattu","sequence":"additional","affiliation":[{"name":"Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Bellinzona, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana, 6900 Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7676-3379","authenticated-orcid":false,"given":"Gabriel","family":"Bronz","sequence":"additional","affiliation":[{"name":"Family Medicine, Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana, 6900 Lugano, Switzerland"},{"name":"Department of Internal Medicine, Regional Hospital of Locarno, Ente Ospedaliero Cantonale, 6900 Locarno, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Camozzi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, H\u00f4pital du Valais, 1950 Sion, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s11908-004-0009-2","article-title":"Virologic diagnosis, viral monitoring, and treatment of Epstein-Barr virus infectious mononucleosis","volume":"6","author":"Jenson","year":"2004","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/MOH.0b013e32834daa08","article-title":"Current diagnosis and management of infectious mononucleosis","volume":"19","author":"Vouloumanou","year":"2012","journal-title":"Curr. Opin. Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1001\/jama.1943.02840370009003","article-title":"Cold hemagglutinins in acute hemolytic reactions","volume":"123","author":"Dameshek","year":"1943","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jclinepi.2018.01.003","article-title":"Registration in the international prospective register of systematic reviews (PROSPERO) of systematic review protocols was associated with increased review quality","volume":"100","author":"Sideri","year":"2018","journal-title":"J. Clin. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"134","author":"Page","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Haddaway, N.R., Collins, A.M., Coughlin, D., and Kirk, S. (2015). The role of Google Scholar in evidence reviews and its applicability to grey literature searching. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0138237"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1182\/blood.2019003808","article-title":"How I treat warm autoimmune hemolytic anemia","volume":"137","author":"Barcellini","year":"2021","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s11912-024-01569-8","article-title":"Cold-antibody autoimmune hemolytic anemia: Its association with neoplastic disease and impact on therapy","volume":"26","author":"Berentsen","year":"2024","journal-title":"Curr. Oncol. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s00431-009-1079-9","article-title":"Swiss Pediatric Surveillance Unit. Hemolytic-uremic syndrome in Switzerland: A nationwide surveillance 1997\u20132003","volume":"169","author":"Schifferli","year":"2010","journal-title":"Eur. J. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.nmd.2013.12.009","article-title":"Swiss Italian Society of Pediatrics. Influenzavirus B-associated acute benign myalgia cruris: An outbreak report and review of the literature","volume":"24","author":"Ferrarini","year":"2014","journal-title":"Neuromuscul. Disord."},{"key":"ref_11","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012). KDIGO clinical practice guideline for acute kidney injury. Kidney Int. Suppl., 2, 1\u2013138."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4205","DOI":"10.1007\/s00431-024-05676-3","article-title":"Transient secondary pseudo-hypoaldosteronism in infants with urinary tract infections: Systematic literature review","volume":"183","author":"Betti","year":"2024","journal-title":"Eur. J. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1177\/000992288502400905","article-title":"Nonparametric methods\u2014Clinical applications","volume":"24","author":"Brown","year":"1985","journal-title":"Clin. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.5694\/j.1326-5377.1973.tb129946.x","article-title":"Severe acute haemolytic anaemia complicating infectious mononucleosis","volume":"2","author":"Tonkin","year":"1973","journal-title":"Med. J. Aust."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1136\/jcp.26.5.332","article-title":"Infectious mononucleosis complicated by acute haemolytic anaemia with a positive Donath-Landsteiner reaction","volume":"26","author":"Wishart","year":"1973","journal-title":"J. Clin. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/ajcp\/61.4.465","article-title":"Auto anti-N immunohemolytic anemia in infectious mononucleosis","volume":"61","author":"Bowman","year":"1974","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_17","first-page":"945","article-title":"Severe haemolysis and unilateral sensorineural deafness in infectious mononucleosis","volume":"217","author":"Petheram","year":"1976","journal-title":"Practitioner"},{"key":"ref_18","first-page":"301","article-title":"Anti-i hemolytic anemia in infectious mononucleosis","volume":"59","author":"Walker","year":"1976","journal-title":"Minn. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/j.1445-5994.1976.tb03997.x","article-title":"Severe haemolytic anaemia complicating infectious mononucleosis","volume":"6","author":"Woodruff","year":"1976","journal-title":"Aust. N. Z. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1159\/000207744","article-title":"Auto-immune haemolytic anemia complicating infectious mononucleosis in a patient with hereditary elliptocytosis","volume":"59","year":"1978","journal-title":"Acta Haematol."},{"key":"ref_21","first-page":"1095","article-title":"Acute hemolytic anemia secondary to infectious mononucleosis","volume":"121","author":"Perkin","year":"1979","journal-title":"Can. Med. Assoc. J."},{"key":"ref_22","first-page":"482","article-title":"Acute hemolytic anemia secondary to infectious mononucleosis","volume":"123","author":"Wentworth","year":"1980","journal-title":"Can. Med. Assoc. J."},{"key":"ref_23","first-page":"160","article-title":"Anemia hemol\u00edtica como complicaci\u00f3n de mononucleosis infecciosa [Hemolytic anemia as a complication of infectious mononucleosis]","volume":"22","year":"1985","journal-title":"An. Esp. Pediatr."},{"key":"ref_24","first-page":"183","article-title":"Life-threatening haemolytic anaemia and infectious mononucleosis. A case report","volume":"67","author":"Silber","year":"1985","journal-title":"S. Afr. Med. J."},{"key":"ref_25","first-page":"1842","article-title":"H\u00e4matologische Komplikationen bei Mononucleosis infectiosa [Hematologic complications in infectious mononucleosis]","volume":"115","author":"Fehr","year":"1985","journal-title":"Schweiz. Med. Wochenschr."},{"key":"ref_26","first-page":"162","article-title":"Acute hemolytic anemia in infectious mononucleosis","volume":"65","author":"Tosato","year":"1986","journal-title":"Boll. Ist. Sieroter. Milan."},{"key":"ref_27","first-page":"485","article-title":"Hemolytic anemia as a complication of Epstein-Barr virus infection: A report of two cases","volume":"3","author":"Gelati","year":"1987","journal-title":"J. Exp. Pathol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/S0046-8177(88)80215-6","article-title":"Epstein-Barr virus infection and hepatic fibrin-ring granulomas","volume":"19","author":"Nenert","year":"1988","journal-title":"Hum. Pathol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/j.1600-0609.1989.tb01257.x","article-title":"Infectious mononucleosis complicated by severe immune hemolysis","volume":"43","author":"Rollof","year":"1989","journal-title":"Eur. J. Haematol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1159\/000204671","article-title":"Successful plasmapheresis in corticosteroid-resistant hemolysis in infectious mononucleosis: Role of autoantibodies against triosephosphate isomerase","volume":"88","author":"Geurs","year":"1992","journal-title":"Acta Haematol."},{"key":"ref_31","first-page":"401","article-title":"Anemia emolitica autoimmune da anticorpi freddi con emoglobinuria secondaria ad infezione da EBV [Autoimmune hemolytic anemia with cold antibodies and hemoglobinuria secondary to EBV infection]","volume":"46","author":"Cataldo","year":"1994","journal-title":"Minerva Pediatr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/j.1742-1241.1995.tb09952.x","article-title":"Haemolytic anaemia complicating Epstein-Barr virus infection","volume":"49","author":"Whitelaw","year":"1995","journal-title":"Br. J. Clin. Pract."},{"key":"ref_33","first-page":"137","article-title":"Index of suspicion. Case 1. Diagnosis: Infectious mononucleosis","volume":"19","author":"Friedman","year":"1998","journal-title":"Pediatr. Rev."},{"key":"ref_34","first-page":"709","article-title":"Intensa ictericia en el curso de una mononucleosis infecciosa por EBV [Intense icterus in the course of EBV infectious mononucleosis]","volume":"88","year":"1996","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1007\/BF02982074","article-title":"Severe autoimmune hemolytic anemia as a potentially fatal complication of EBV infectious mononucleosis","volume":"74","year":"2001","journal-title":"Int. J. Hematol."},{"key":"ref_36","first-page":"288","article-title":"Esplenectom\u00eda en paciente con betatalasemia intermedia y anemia hemol\u00edtica grave [Splenectomy in a patient with beta thalassemia intermedia and severe hemolytic anemia]","volume":"48","author":"Padilla","year":"2001","journal-title":"Rev. Esp. Anestesiol. Reanim."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1002\/dc.2048","article-title":"Serous fluid cytology as a means of detecting hemophagocytosis in Epstein-Barr virus-induced autoimmune hemolytic anemia","volume":"25","author":"Zaharopoulos","year":"2001","journal-title":"Diagn. Cytopathol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1053\/jinf.2002.0993","article-title":"Fulminant hepatic failure and autoimmune hemolytic anemia associated with Epstein-Barr virus infection","volume":"45","author":"Palanduz","year":"2002","journal-title":"J. Infect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S0248-8663(04)00232-2","article-title":"Mononucl\u00e9ose infectieuse et an\u00e9mie h\u00e9molytique autoimmune \u00e0 agglutinines froides d\u2019isotype IgG: \u00c0 propos d\u2019un cas [Autoimmune hemolytic anemia caused by IgG cold agglutinins after infectous mononucleosis]","volume":"25","author":"Gruson","year":"2004","journal-title":"Rev. Med. Interne."},{"key":"ref_40","first-page":"831","article-title":"Severe systemic autoimmune disease associated with Epstein-Barr virus infection","volume":"26","author":"Sevilla","year":"2004","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1111\/j.1537-2995.2006.01028.x","article-title":"Transfusion medicine illustrated. Erythrophagocytosis in Epstein-Barr virus IgM-mediated hemolytic anemia","volume":"46","author":"Merino","year":"2006","journal-title":"Transfusion"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.ejim.2006.09.024","article-title":"Acute hemolytic anemia following infectious mononucleosis","volume":"18","author":"Garefalakis","year":"2007","journal-title":"Eur. J. Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/MPH.0b013e3180590c11","article-title":"Successful plasmapheresis for extreme hyperbilirubinemia caused by acute Epstein-Barr virus","volume":"29","author":"Place","year":"2007","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00508-007-0821-4","article-title":"Cytomegalovirus reactivation after low-dose steroid treatment for hemolytic anemia in a patient with primary Epstein-Barr virus infection","volume":"119","author":"Milotic","year":"2007","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/MPH.0b013e318161a9f9","article-title":"A 13-year-old girl with cold agglutinin syndrome caused by anti-i","volume":"30","author":"Mason","year":"2008","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"bcr12.2008.1390","DOI":"10.1136\/bcr.12.2008.1390","article-title":"Infectious mononucleosis with secondary cold agglutinin disease causing autoimmune haemolytic anaemia","volume":"2009","author":"Malhotra","year":"2009","journal-title":"BMJ Case Rep."},{"key":"ref_47","first-page":"14","article-title":"Direct antiglobulin test (Coombs) positive autoimmune hemolytic anemia induced by Epstein-Barr virus infectious mononucleosis in two children","volume":"3","author":"Kaya","year":"2011","journal-title":"J. Infect. Dis. Immun."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s12185-012-1047-4","article-title":"Splenic infarction, warm autoimmune hemolytic anemia and antiphospholipid antibodies in a patient with infectious mononucleosis","volume":"95","author":"Cull","year":"2012","journal-title":"Int. J. Hematol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1477-9560-10-4","article-title":"Cold autoimmune haemolytic anaemia secondary to Epstein Barr virus infection presenting with peripheral gangrene: Case report","volume":"10","author":"Karunarathne","year":"2012","journal-title":"Thromb. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1309\/LM9OWRF64OGQODEA","article-title":"Fatal autoimmune hemolytic anemia due to immunoglobulin G autoantibody exacerbated by Epstein-Barr virus","volume":"46","author":"Fadeyi","year":"2015","journal-title":"Lab. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jiph.2015.06.011","article-title":"A rare case of acute pancreatitis and life-threatening hemolytic anemia associated with Epstein-Barr virus infection in a young healthy adult","volume":"9","author":"Singh","year":"2016","journal-title":"J. Infect. Public Health"},{"key":"ref_52","first-page":"388","article-title":"Severe acute hepatitis and cold agglutinin-related hemolytic anemia secondary to prime infection with Epstein-Barr virus","volume":"109","year":"2017","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1111\/apa.14462","article-title":"Epstein-Barr virus infection was associated with nephrotic syndrome, severe thrombocytopenia and Coombs-positive haemolytic anaemia","volume":"107","author":"Amer","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Dematapitiya, C., Perera, C., Chinthaka, W., Senanayaka, S., Tennakoon, D., Ameer, A., Ranasinghe, D., Warriyapperuma, U., Weerarathna, S., and Satharasinghe, R. (2019). Cold type autoimmune hemolytic anemia\u2014A rare manifestation of infectious mononucleosis; serum ferritin as an important biomarker. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-3722-z"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/MPH.0000000000001184","article-title":"EBV-related cold agglutinin disease presenting with conjugated hyperbilirubinemia: A pediatric case report and mini review","volume":"41","author":"Mantadakis","year":"2019","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1159\/000509742","article-title":"Infectious mononucleosis causing acute liver failure and hemolytic anemia in a patient with underlying hereditary hemochromatosis","volume":"13","author":"Forsberg","year":"2020","journal-title":"Case Rep. Oncol."},{"key":"ref_57","first-page":"199","article-title":"Autoimmune hemolytic anemia developing secondary to Epstein-Barr virus infection: A case report","volume":"5","author":"Ince","year":"2020","journal-title":"Online Turk. J. Health Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"A949","DOI":"10.1016\/j.chest.2020.08.884","article-title":"Epstein-Barr virus infectious mononucleosis with cholestatic hepatitis and autoimmune hemolytic anemia","volume":"158","author":"Siddiqui","year":"2020","journal-title":"Chest"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1016\/j.jemermed.2019.11.043","article-title":"A rare presentation of Epstein-Barr virus infection","volume":"58","author":"Teijido","year":"2020","journal-title":"J. Emerg. Med."},{"key":"ref_60","first-page":"e16","article-title":"An icteric tongue","volume":"385","author":"Orkin","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_61","first-page":"26","article-title":"A rare case of heterophile negative EBV CA IgM positive infectious mononucleosis complicated by cold autoimmune hemolytic anemia","volume":"11","author":"Tony","year":"2021","journal-title":"Indian J. Appl. Res."},{"key":"ref_62","first-page":"e26371","article-title":"A Case of Warm Autoimmune Hemolytic Anemia Secondary to Epstein-Barr Virus Infection","volume":"14","author":"Abidoye","year":"2022","journal-title":"Cureus"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1016\/j.htct.2023.09.168","article-title":"Warm autoimmune hemolytic anemia associated with Epstein-Barr virus infection","volume":"45","author":"Junior","year":"2023","journal-title":"Hematol. Transfus. Cell Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"621","DOI":"10.7861\/clinmed.2023-0415","article-title":"\u2019A kiss that took my legs away\u2019: A rare presentation of Epstein-Barr virus in the older population","volume":"23","author":"Mahmood","year":"2023","journal-title":"Clin. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e1014","DOI":"10.1097\/MPH.0000000000002687","article-title":"Epstein-Barr virus-induced paroxysmal cold hemoglobinuria in a 17-year-old male","volume":"45","author":"Schmittau","year":"2023","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e218","DOI":"10.1097\/INF.0000000000004274","article-title":"A rare case presentation: EBV-related cold agglutinin disease and venous thrombosis","volume":"43","year":"2024","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_67","first-page":"209","article-title":"Epstein-Barr Virus-induced warm autoimmune hemolytic anemia","volume":"41","author":"Bilal","year":"2024","journal-title":"Turk. J. Haematol."},{"key":"ref_68","first-page":"e52179","article-title":"Cold agglutinin syndrome and hemophgocytic lymphohistiocytosis: An unusual combination caused by Epstein-Barr virus infection","volume":"16","author":"Gouveia","year":"2024","journal-title":"Cureus"},{"key":"ref_69","first-page":"e62466","article-title":"A case of secondary autoimmune hemolytic anemia successfully treated with rituximab","volume":"16","author":"Thomas","year":"2024","journal-title":"Cureus"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.hoc.2015.01.002","article-title":"Cold agglutinin-mediated autoimmune hemolytic anemia","volume":"29","author":"Berentsen","year":"2015","journal-title":"Hematol. Oncol. Clin. North. Am."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1056\/NEJMra2033982","article-title":"Autoimmune hemolytic anemias","volume":"385","author":"Berentsen","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"100648","DOI":"10.1016\/j.blre.2019.100648","article-title":"Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting","volume":"41","author":"Barcellini","year":"2020","journal-title":"Blood Rev."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/ckj\/sfx121","article-title":"Clinical profile and outcome of pigment-induced nephropathy","volume":"11","author":"Sakthirajan","year":"2018","journal-title":"Clin. Kidney J."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jcv.2017.03.016","article-title":"Acute kidney injury in symptomatic primary Epstein-Barr virus infectious mononucleosis: Systematic review","volume":"91","author":"Moretti","year":"2017","journal-title":"J. Clin. Virol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.2215\/CJN.11290821","article-title":"Drug-induced acute kidney injury","volume":"17","author":"Perazella","year":"2022","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/1743-422X-5-47","article-title":"Severe cytomegalovirus infection in apparently immunocompetent patients: A systematic review","volume":"5","author":"Rafailidis","year":"2008","journal-title":"Virol. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1590\/S1413-86702009000100018","article-title":"Mycoplasma pneumoniae associated with severe autoimmune hemolytic anemia: Case report and literature review","volume":"13","author":"Khan","year":"2009","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"655","DOI":"10.3324\/haematol.2010.036053","article-title":"New insights into childhood autoimmune hemolytic anemia: A French national observational study of 265 children","volume":"96","author":"Aladjidi","year":"2011","journal-title":"Haematologica"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/bjh.16786","article-title":"Simultaneous onset of COVID-19 and autoimmune haemolytic anaemia","volume":"190","author":"Lopez","year":"2020","journal-title":"Br. J. 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