SEVERE LOW-TITER COLD-HEMAGGLUTININ DISEASE RESPONSIVE TO STEROID PULSE THERAPY

We report the case of a 12-year-old boy suffering from severe low-tite r cold-hemagglutinin disease with excruciating colicky abdominal pain, jaundice, and acute hemolytic anemia requiring transfusion. Cold hema gglutinins of the IgM type and a positive direct antiglobulin test, pr edominantly against C3d, were found. Steroid pulse therapy with 20 mg/ kg body wt. methylprednisolone for 3 consecutive days was given. Abdom inal pain disappeared within 12 h of the first steroid infusion and he molysis was halted. We conclude that a therapeutic trial with steroid pulse therapy in severe low-titer cold-hemagglutinin disease is warran ted.