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The diagnosis of cold-antibody AIHA is made with the presence of hemolytic anemia, reticulocytosis, hyperbilirubinemia, increased LDH level, and classically, a negative Coombs test with anti-IgG and a positive Coombs test with anti-C3 (7).
Those having congenital defect autoimmune hemolysis in moribund condition low APGAR (Appearance Pulse Grimace Activity Respiration) score acute hemolysis characterized by reticulocytosis and established maternal positive status for hepatitis B and C virus were excluded from study.
Additional findings include increased indirect bilirubin, reticulocytosis, and a sharp decrease in haptoglobin.
Reticulocytosis and plasma erythropoietin increases indicated that this was similar to the mechanism in this patient.
She developed anaem ia and reticulocytosis on day 4 consistent with haemolysis for which she received a unit of packed red blood cells.
2 g/dL; reference 9-14 g/dL) and reticulocytosis (260,000 x [10.
Inappropriately low reticulocytosis has been observed in malaria patients suggesting that insufficient erythropoiesis is a major factor.
The presence of normal coagulation results, which favor TTP, as well as evidence of reticulocytosis and intravascular hemolysis (indicated by elevated LDH and low haptoglobin) led to the decision to initiate TPE.
Cold agglutinins appear to be more specific for I antigen of the red blood cell surface and often result in mild, subclinical hemolysis and mild reticulocytosis.
Infants have a peripheral blood reticulocytosis of four percent to six percent at birth and demonstrate 3 to 10 nucleated red blood cells (NRBC) per 100 white blood cells.
Peripheral smear findings and reticulocytosis can also show evidence of hemolysis.