Infectious mononucleosis complicated by acute hemolytic anemia due to anti-hi antibody

Abstract

A case study of a 25-year old man with a three-day history of intermittent generalized abdominal pain, persistent nausea and slight vomiting is hereby described. The clinical investigations established the diagnosis of infectious mononucleosis complicated by a severe hemolytic anemia due to a different antibody of HI-specificity. The treatment consisted of a transfusion of four units of packed cells and started on oral prednisolone in a daily dosage of 40 mg. There was a rapid improvement in his symptoms and a return of the temperature to normal. The patient's hemolytic anemia followed the pattern described by Dacie (1960). An acute onset with high fever, rapidly advancing anemia and jaundice is characteristic. Hemoglobinuria is uncommon, but has been reported in at least four cases (Dacie, 1960). It is of great interest that the patient did not show evidence of anti-i antibody activity. Further investigation revealed that the antibody had an anti-HI specificity.