Louie E K, Ault K A, Smith B R, Hardman E L, Quesenberry P J
Scand J Haematol. 1985 Sep;35(3):264-9. doi: 10.1111/j.1600-0609.1985.tb01705.x.
Haemolytic anaemia complicating Mycoplasma infection has usually been attributed to IgM cold agglutinins. This report describes a patient with pneumonia due to Mycoplasma pneumoniae in whom severe haemolysis persisted despite declining thermal amplitude and titre of cold agglutinins as the infection resolved. Class-specific anti-globulin (Coombs) testing defined an IgG warm agglutinin coating the patient's erythrocytes that was distinct from the IgM cold agglutinin identified by Sephadex G-200 gel filtration and dithiothreitol inactivation. Monoclonal IgM(gamma) and IgK(k) circulating proteins were identified and immuno-electrophoresis of the cold agglutinin-containing cryoglobulin fraction identified the cold agglutinin as an IgM(gamma). In this patient initially presumed to have cold agglutinin induced haemolysis secondary to Mycoplasma infection, an IgG warm agglutinin was identified as the aetiology for the patient's haemolysis, underscoring the clinical relevance of careful evaluation of the mechanism of haemolysis accompanying Mycoplasma pneumonia.
溶血性贫血并发支原体感染通常归因于IgM冷凝集素。本报告描述了一名因肺炎支原体感染导致肺炎的患者，尽管随着感染的消退冷凝集素的热振幅和滴度下降，但严重溶血仍持续存在。特异性类别抗球蛋白（库姆斯）试验确定有一种IgG温凝集素包被患者的红细胞，这与通过葡聚糖G-200凝胶过滤和二硫苏糖醇灭活鉴定的IgM冷凝集素不同。鉴定出单克隆IgM（γ）和IgK（κ）循环蛋白，对含冷凝集素的冷球蛋白组分进行免疫电泳，确定冷凝集素为IgM（γ）。在这名最初被认为因支原体感染继发冷凝集素诱导溶血的患者中，鉴定出一种IgG温凝集素是患者溶血的病因，强调了仔细评估支原体肺炎伴发溶血机制的临床相关性。
