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Donath-Landsteiner hemolytic anemia with erythrophagocytosis and platelet phagocytosis in peripheral smear: Rare findings


1 Consultant Pathologist, Department of Laboratory Medicine, Yashoda Hospitals, Hyderabad, Telangana, India
2 Consultant Biochemist Department of Laboratory Medicine, Yashoda Hospitals, Hyderabad, Telangana, India
3 Consultant Transfusion Medicine, Department of Transfusion Medicine, Yashoda Hospitals, Hyderabad, Telangana, India

Correspondence Address:
Majed Abdul Basit Momin,
Department of Laboratory Medicine, Yashoda Hospital, Malakpet, Nalgonda X-Roads, Hyderabad - 500 036, Telangana
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_373_20

The Donath-Landsteiner (DL) hemolytic anemia or paroxysmal cold hemoglobinuria (PCH) is a rare subtype of autoimmune hemolytic anemia (AIHA). We report here a case of a 22-year-old young female who presented with acute onset shortness of breath. Routine hematological investigation revealed erythrophagocytosis and platelet phagocytosis by monocytes in peripheral blood smear, which are rarely reported in AIHA, especially the DL. The unusual blood smear findings directed the pathologists to initiate workup for hemolytic anemia that yielded positive results in direct Coombs test C3d (Complement) and direct DL test. The findings confirmed the case as DL hemolytic anemia. To the best of our knowledge, this is the first report of both erythrophagocytosis and platelet phagocytosis in peripheral blood smear in PCH.


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    -  Basit Momin MA
    -  Aluri A
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