[Fulminant autoimmune cold-type hemolysis with marked elevation of monothermic cold agglutinins. Successful therapy with membrane plasmapheresis].

Autoimmune hemolytic anemia associated with cold autoantibodies is rare in infancy. In a 7 months old infant with severe hemolysis, a hemoglobin of 5.9 g/dl and a cold agglutinin titer of 1:8000, even the transfusion of warmed, packed red cells (37 degrees C) lead to hemolysis. Hemoglobin fell to 2.8 g/dl despite prevention of exposure to cold, parenteral steroids and immunoglobulins. Cold agglutinin titer fell to 1:8 after plasma separation. Subsequent transfusion did not lead to hemolysis and permanent remission was achieved.