Severe Intravascular Hemolysis and Acute Kidney Injury Triggered by Mycoplasma-Associated Cold Agglutinin Disease: A Case Report.
Introduction: Mycoplasma pneumoniae infection commonly causes mild respiratory illness, but cold agglutinin syndrome (CAS) is an uncommon extrapulmonary complication. CAS typically results in mild, predominantly extravascular hemolysis; however, severe intravascular hemolysis and acute kidney injury...
| Published in: | Clinical Medicine Insights: Case Reports Vol. 19; pp. 1 - 6 |
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| Main Authors: | , |
| Format: | case study tables/charts Journal Article |
| Published: |
Sage Publications Inc.
3/18/2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192372846&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192372846 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795476 B3KM jtl: Clinical Medicine Insights: Case Reports issn: 11795476 maglogo: Y pubinfo: dt: 3/18/2026 vid: 19 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192372846 192372846 192372846 10.1177/11795476261426064 192372846 ppf: 1 ppct: 5 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Severe Intravascular Hemolysis and Acute Kidney Injury Triggered by Mycoplasma-Associated Cold Agglutinin Disease: A Case Report. aug: au: Elmezayen, Ziad W. Adi, Mohammad affil: Faculty of Medicine, Kafr Elsheikh University, Egypt sug: subj: Anemia, Hemolytic, Autoimmune Diagnosis Pneumonia, Mycoplasma Complications Hemolysis Kidney Failure, Acute Diagnostic Tests, Routine Rare Diseases Female Middle Age Blood Transfusion Methods Hemodialysis Severity of Illness Respiratory Tract Infections Complications Fatigue Etiology Jaundice Etiology Anuria Etiology Early Diagnosis Coombs' Test Immunoglobulins Serology Antibiotics Therapeutic Use Continuous Renal Replacement Therapy Methods Creatinine Blood Agglutination Tests Recovery Kidney Function Tests Physical Examination Biological Markers Rituximab Administration and Dosage Emergency Service Radiography, Thoracic Kidney Ultrasonography Administration, Oral Middle Aged: 45-64 years Female ab: Introduction: Mycoplasma pneumoniae infection commonly causes mild respiratory illness, but cold agglutinin syndrome (CAS) is an uncommon extrapulmonary complication. CAS typically results in mild, predominantly extravascular hemolysis; however, severe intravascular hemolysis and acute kidney injury (AKI) are rare. Case presentation: A 59-year-old woman presented with profound weakness, jaundice, dark urine, and anuria following a mild upper respiratory illness. Laboratory evaluation revealed severe intravascular hemolysis, markedly elevated LDH activity, undetectable hemoglobin (Hb) level, hemoglobinuria, and AKI. Direct antiglobulin testing was positive for C3d only, and the cold agglutinin titer was markedly elevated (1:2048). Mycoplasma pneumoniae IgM serology was positive. She required warmed blood transfusions, antibiotics, thermal protection, and continuous renal replacement therapy. Over 10 days, hemolysis-related laboratory parameters and serum creatinine level improved significantly. Conclusion: This case illustrates a rare and severe form of Mycoplasma pneumoniae-associated CAS presenting with massive intravascular hemolysis and AKI. Early recognition and supportive interventions—particularly warmed transfusions and renal support—were critical to recovery. Clinicians should consider cold agglutinin-mediated hemolysis in patients with dark urine and AKI following respiratory infection. pubtype: Academic Journal doctype: case study tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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