Idiopathic Autoimmune Hemolytic Anemia a Report of Two Cases in Infants

Two cases of idiopathic autoimmune hemolytic anemia, proved by the positive Coombs' test, are presented. Both cases showed extreme anemia and mild jaundice without preceding bacterial or viral infections. No history of drug ingestion before the onset could be elicited in both cases. The first case, a 7-month-old female baby, having positive direct and indirect Coombs' tests at the onset, was unresponsive to prednisolone therapy, but a prompt and progressive increase of the hemoglobin value was observed after the institution of cyclophosphamide. The direct Coombs' test never reverted to negative in the course of the disease, and the patient died of pneumonia 3 months after the onset of the illness. The second case was an 8-month-old male baby with only a positive direct Coombs' test, but a negative indirect Coombs' test initially. The blood counts returned to normal about 1 month after prednisolon therapy. A low dose of prednisolone was maintained for another 3 months until the Coombs' test gradually reverted to negative. A follow-up study for 18 months has thus far revealed no recurrence.