[Autoimmune hemolytic anemia with Donath-Landsteiner antibodies and antinuclear factors during the course of chronic-aggressive hepatitis].

With the onset of a remission phase of chronic aggressive hepatitis in a young female patient, two different auto-antibodies were found which had not previously been in evidence. These antibodies were identified as Donath-Landsteiner antibodies, the cause of a secondary auto-immune hemolytic anemia observed during this period, and anti-nuclear antibodies. Both antibodies were of the IgG class, both could be adsorbed onto the patient's own erythrocytes as well as P1-positive test erythrocytes, and both antibodies were present in the subsequent erythrocyte eluate. Separation of the two antibodies present in the serum as well as in the antibody-containing erythrocyte eluate was possible by absorption of the antinuclear factors using preparations of liver and thymus cell nuclei, but the anti-erythrocyte activity was not diminished by this procedure. Rapid remission of the auto-immune hemolytic anemia was achieved by a therapeutic application of corticosteroids. Long-term therapy has resulted in no recurrence of the auto-immune hemolytic anemia until now.