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820 Part VI: The Erythrocyte Chapter 53: Hemolytic Anemia Resulting from Infections with Microorganisms 821

234 patients, 55 were found to have an antecedent bacterial infection, 18. Gundersen SG, Bjoerneklett A, Bruun JN: Severe erythroblastopenia and hemolytic
10
18 of these exhibiting an “unequivocal etiologic relationship” of infec- anemia during a hepatitis A infection. Scand J Infect Dis 21:225, 1989.
tion to anemia. However, the principal evidence for such a relation- 19. Kanematsu T, Nomura T, Higashi K, Ito M: Hemolytic anemia in association with viral
hepatitis. Nippon Rinsho 54:2539, 1996.
ship was a temporal one. A number of viral agents, including measles, 20. Urganci N, Akyildiz B, Yildirmak Y, Ozbay G: A case of autoimmune hepatitis and
cytomegalovirus, varicella, herpes simplex, influenzas A and B, Epstein- autoimmune hemolytic anemia following hepatitis A infection. Turk J Gastroenterol
14:204, 2003.
Barr, human immunodeficiency virus 24–26 (Chap. 82), and coxsackiev- 21. Gurgey A, Yuce A, Ozbek N, Kocak N: Acute hemolysis in association with hepatitis B
irus have also been associated with immune hemolytic disease. 10,121 infection in a child with beta-thalassemia trait. Turk J Pediatr 36:259, 1994.
Various mechanisms have been postulated, including absorption of 22. Etienne A, Gayet S, Vidal F, et al: Severe hemolytic anemia due to cold agglutinin com-
immune complexes and complement, cross-reacting antigen, and a true plicating untreated chronic hepatitis C: Efficacy and safety of anti-CD20 (rituximab)
treatment. Am J Hematol 75:243, 2004.
autoimmune state with possible loss of tolerance secondary to the infec- 23. Shurin SB, Anderson P, Zollinger J, Rathbun RK: Pathophysiology of hemolysis in
10
tious organism. Histopathologic and sometimes virologic evidence of infections with Haemophilus influenzae type B. J Clin Invest 77:1340, 1986.
infection with cytomegalovirus has been reported in a high percentage 24. Rheingold SR, Burnham JM, Rutstein R, Manno CS: HIV infection presenting as severe
122
of children with lymphadenopathy and hemolytic anemia. A positive autoimmune hemolytic anemia with disseminated intravascular coagulation in an
infant. J Pediatr Hematol Oncol 26:9, 2004.
antiglobulin reaction was demonstrated in some of these patients, and 25. Koduri PR, Singa P, Nikolinakos P: Autoimmune hemolytic anemia in patients infected
it has been suggested that some cases of “idiopathic autoimmune hemo- with human immunodeficiency virus-1. Am J Hematol 70:174, 2002.
lytic anemia” are in reality caused by cytomegalovirus infection. 122 26. Saif MW: HIV-associated autoimmune hemolytic anemia: An update. AIDS Patient
Care STDS 15:217, 2001.
The high cold agglutinin titer that sometimes develops in the 27. Watanabe T: Hemolytic uremic syndrome associated with influenza A virus infection.
course of Mycoplasma pneumoniae pneumonia (Chap. 54) may occa- Nephron 89:359, 2001.
1,33
sionally result in hemolytic anemia or compensated hemolysis, 28. Asaka M, Ishikawa I, Nakazawa T, et al: Hemolytic uremic syndrome associated with
although most patients with high cold agglutinin titers do not become influenza A virus infection in an adult renal allograft recipient: Case report and review
of the literature. Nephron 84:258, 2000.
anemic. The red cells of a number of patients with kala azar were found 29. Trowbridge AA, Green JB III, Bonnett JD, et al: Hemolytic anemia associated with lep-
to be agglutinated with anticomplement and anti–non-γ-globulin tospirosis. Morphologic and lipid studies. Am J Clin Pathol 76:493, 1981.
serum. Both splenic and hepatic sequestration of red cells appears to 30. Woodruff AW, Topley E, Knight R, Downie CGB: The anaemia of kala azar. Br J Haema-
30
tol 22:319, 1972.
occur in this disease. 13 31. Ozen S, Damarguc I, Besbas N, et al: A case of mumps associated with acute hemolytic
Microangiopathic hemolytic anemia is discussed in detail in crisis resulting in hemoglobinuria and acute renal failure. J Med 25:255, 1994.
Chaps. 51 and 129. This disorder may be triggered by a variety of infec- 32. Kuo PH, Yang PC, Kuo SS, Luh KT: Severe immune hemolytic anemia in disseminated
tuberculosis with response to antituberculosis therapy. Chest 119:1961, 2001.
tions, some of which are caused by well-characterized organisms such 33. Fiala M, Myhre BA, Chinh LT, et al: Pathogenesis of anemia associated with Mycop-
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as Shiga toxin-producing Escherichia coli, Shigella dysenteriae type 1, lasma pneumoniae. Acta Haematol 51:297, 1974.
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Campylobacter, and Aspergillus. 1 34. Chambers LA, Rauck AM: Acute transient hemolytic anemia with a positive Don-
ath-Landsteiner test following parvovirus B19 infection. J Pediatr Hematol Oncol
18:178, 1996.
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