A case of hemolytic anemia associated with interstitial lung disease, arthralgia and fever caused by Mycoplasma pneumoniae
Pulmonary interstitiopathies became the most diagnosed forms of pneumonia in 2020 due to the coronavirus (COVID-19) pandemic. The spectrum of interstitiopathies is broad and includes idiopathic diseases and secondary forms. In April 2020, a 36-year-old man was admitted to our department for arthralgias, fever, asthenia, cough, and dyspnea. In January 2020, fever, cough, arthralgias, and asthenia appeared. In April, his general condition worsened with the development of macrohematuria, malaise, and intense asthenia. On admission, the patient presented pale, asthenic, and symptomatic for dyspnea and arthralgias. There was objective joint pain in the small joints of the hands, elbow, and knees with morning stiffness and decreased strength. Computed tomography of the chest documented ground-glass opacities in both lung fields. He performed 2 swabs for severe acute respiratory syndrome-related coronavirus 2, which were negative. On hematochemical examination: immunoglobulin (IgM) 332 mg/dL and ferritin 700.2 ng/mL. At venous blood smear peripheral venous blood, agglutination of erythrocytes. The serology (IgM) for Mycoplasma pneumoniae was positive with agglutinins in the serum; doxaciclina was started. There was a progressive normalization of hemoglobin levels, cold agglutinins were gradually reduced and were no longer detected at 15 days after the start of treatment. At one month after discharge, pulmonary function had fully recovered, and the picture of hemolytic anemia was resolved.
Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013;188:733-48. DOI: https://doi.org/10.1164/rccm.201308-1483ST
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733. DOI: https://doi.org/10.1056/NEJMoa2001017
Congbin Y, Aibin L, Congli Y, et al. Overexpression of complement receptor type I (cr1, cd35) on erythrocytes in patients with hemoplasma infection. Microbiol Immunol 2010;54:460-5. DOI: https://doi.org/10.1111/j.1348-0421.2010.00240.x
Smith BO, Mallin RL, Krych-Goldberg M, et al. Structure of the c3b binding site of cr1 (cd35), the immune adherence receptor. Cell 2002;108:769-80. DOI: https://doi.org/10.1016/S0092-8674(02)00672-4
Kikkawa S, Matsumoto M, Sasaki T, et al. Complement activation in mycoplasma fermentans- induced mycoplasma clearance from infected cells: probing of the organism with monoclonal antibodies against m161ag. Infect Immun 2000;68:1672-80. DOI: https://doi.org/10.1128/IAI.68.3.1672-1680.2000
Landsteiner K. Über beziehungen zwischen dem blutserum und den korperzeller. Munch Med Worchenschr 1903;50:1812.
Clough MC, Richter IM. A study of an autoagglutinin occuring in a human serum. Johns Hopkins Hosp Bull 1918;29:86.
Iwai S, Mei-Sai N. Etiology of Raynaud’s disease. Jpn Med World 1926;6:345.
Schubothe H. The cold hemagglutinin disease. Semin Hematol 1966;3:27.
Petz LD, Garraty G. Acquired immune hemolytic anemias. New York: Churchill Livingstone 1980. pp 63-76.
Geoff D. Human blood groups. London: Blackwell Science, Ltd.; 1995. pp 53-61.
- Abstract views: 200
- PDF: 153
Copyright (c) 2021 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.