PMC4334594_01
Donath-Landsteiner antibody test. Hemolysis of donor erythrocytes was observed when patient serum (tube 7) or a mixture of patient serum and normal serum (to provide complement; tube 9) was incubated at 0 C for 30 minutes, followed by 37 C for 60 minutes. Little or no hemolysis was seen when patient serum or mixed serum was incubated at 0 C for 90 minutes (tubes 1 and 3) or 37 C for 90 minutes (tubes 4 and 6). No hemolysis was observed in control tubes containing normal serum only (tubes 2, 5, 8).
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Fig1
A Donath Landsteiner antibody test was positive (Figure 1), confirming the diagnosis of PCH.
Time course of hemoglobin and lactic acid dehydrogenase (LDH) values.
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Fig2
Over the next 48 hours, the patient's hemoglobin declined to 7.3 g/dL (Figure 2). Her hemoglobin and LDH normalized by day 42 (Figure 2).