The Donath-Landsteiner test is a blood test to detect harmful antibodies related to a rare disorder called paroxysmal cold hemoglobinuria . These antibodies form and destroy red blood cells when the body is exposed to cold temperatures.

What are the characteristics of the Donath-Landsteiner antibody?

The Donath-Landsteiner (DL) test is a serologic test used to detect the presence of a biphasic hemolysin. This autoantibody is seen in patients with paroxysmal cold hemoglobinuria. The test relies on the characteristic cold binding of an IgG autoantibody with specificity to the P blood group antigen.

What is the process involved in paroxysmal cold hemoglobinuria?

Paroxysmal cold hemoglobinuria (PCH) is a very rare subtype of autoimmune hemolytic anemia (AIHA, see this term), caused by the presence of cold-reacting autoantibodies in the blood and characterized by the sudden presence of hemoglobinuria, typically after exposure to cold temperatures.

What blood group system is affected by Donath-Landsteiner antibody?

The Donath-Landsteiner autoantibody is a type of IgG antibody; its target is the P blood group antigen, present on the red cells of almost all individuals.

Which anemia is caused by an IgG biphasic Donath-Landsteiner antibody with P specificity which fixes complement to Rbcs in the cold less than 20 C?

Paroxysmal cold hemoglobinuria PCH is a cold-induced autoimmune hemolytic anemia associated with an IgG antibody, usually with anti-P specificity; a positive Donath-Landsteiner test; and, frequently, a recent history of a viral infection.

What causes Maha?

Historically, the two major causes of MAHA, thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS), have been indiscriminately intertwined. The pathology, molecular pathogenesis, pathophysiology, clinical features, and management of TTP and aHUS are provided here.

Is autoimmune hemolytic anemia serious?

Autoimmune hemolytic anemia (AIHA) is a group of rare but serious blood disorders. They occur when the body destroys red blood cells more rapidly than it produces them. A condition is considered idiopathic when its cause is unknown. Autoimmune diseases attack the body itself.

What is Evans syndrome?

Evans syndrome is a rare disorder in which the body’s immune system produces antibodies that mistakenly destroy red blood cells, platelets and sometimes certain white blood cell known as neutrophils. This leads to abnormally low levels of these blood cells in the body (cytopenia).

When do you see Heinz bodies?

Heinz bodies may be present in patients with glucose-6-phosphate dehydrogenase (G6PD), or FAD f(adenine dinucleotide deficiency), i.e. methemoglobinemia. [6] it may also indicate unstable hemoglobin, e.g. HB Koln.

What is paroxysmal cold hemoglobinuria?

Paroxysmal cold hemoglobinuria (PCH, also called Donath-Landsteiner hemolytic anemia or Donath-Landsteiner syndrome) is an uncommon type of autoimmune hemolytic anemia (AIHA) in which autoantibodies to red blood cells bind to the cells in cold temperatures and fix complement, which can cause intravascular hemolysis …

Which antibody is associated with paroxysmal cold hemoglobinuria?

Paroxysmal cold hemoglobinuria (PCH) is an acquired hemolytic anemia caused by immunoglobulin G (IgG) antibodies that sensitize red blood cells (RBCs) at cold temperatures by fixing complement to the RBCs causing intravascular hemolysis on rewarming.

What are the symptoms of PCH?


What does P stands for in the P blood group system?

P1PK (formerly: P) is a human blood group system (International Society of Blood Transfusion system 003) based upon the A4GALT gene on chromosome 22. The P antigen (later renamed P1) was first described by Karl Landsteiner and Philip Levine in 1927.

How do you treat paroxysmal cold hemoglobinuria?

The mainstay of treatment for paroxysmal cold hemoglobinuria is supportive care and the avoidance of cold exposure. Patients require hospitalization to monitor and treat complications associated with severe anemia secondary to massive hemolysis.

What is the basic hematological defect seen in patients with thalassemia major?

Thalassemia is a blood disorder passed down through families (inherited) in which the body makes an abnormal form or inadequate amount of hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen. The disorder results in large numbers of red blood cells being destroyed, which leads to anemia.

What is biphasic hemolysin?

Biphasic hemolysins bind to RBCs at low temperatures and activate complement to produce in vitro hemolysis at warmer temperatures (37C), whereas monophasic hemolysins bind to RBCs and activate complement at the same temperature.

What is cold agglutinin test?

A cold agglutinins blood test is done to check for conditions that cause the body to make certain types of antibodies called cold agglutinins. Cold agglutinins are normally made by the immune system in response to infection. They cause red blood cells to clump together (agglutinate) at low temperatures.

Can cold weather cause anemia?

Cold agglutinin disease (CAD) is a condition that makes your body’s immune system attack your red blood cells and destroy them. It’s triggered by cold temperatures, and it can cause problems that range from dizziness to heart failure. It’s also called cold antibody hemolytic anemia.


MAHA is considered to be TTP unless a more likely alternative diagnosis is readily apparent. The immediate treatment for TTP is emergent plasma exchange. In TTP, platelet transfusions can worsen the disease and should not be administered, unless life-threatening anemia or bleeding is present.

What is MAHA in hematology?

Microangiopathic hemolytic anemia (MAHA) MAHA is a descriptive term for non-immune hemolysis (ie, Coombs-negative hemolysis) resulting from intravascular red blood cell fragmentation that produces schistocytes on the peripheral blood smear (picture 1) [1].


Introduction: Both disseminated intravascular coagulation (DIC) and thrombotic microangiopathy (TMA) cause microvascular thrombosis associated with thrombocytopenia, bleeding tendency and organ failure.

What is the treatment for autoimmune hemolytic anemia?

Autoimmune Hemolytic Anemia Treatment Doctors usually first prescribe steroids, such as hydrocortisone or prednisone, to stop your immune system from attacking your red blood cells. A medicine called rituximab may make steroids work even better. If you don’t improve, you may need surgery to remove your spleen.

What are the signs and symptoms of hemolytic anemia?

What are the symptoms of hemolytic anemia?

What is pernicious anemia caused by?

A lack of vitamin B12 (vitamin B12 deficiency) causes the signs and symptoms of pernicious anemia. Without enough vitamin B12, your body can’t make enough healthy red blood cells, which causes anemia.

What is Fanconi’s Anaemia?

Fanconi anemia is a rare disease passed down through families (inherited) that mainly affects the bone marrow. It results in decreased production of all types of blood cells. This is the most common inherited form of aplastic anemia. Fanconi anemia is different from Fanconi syndrome, a rare kidney disorder.

What does polycythemia vera mean?

Listen to pronunciation. (PAH-lee-sy-THEE-mee-uh VAYR-uh) A disease in which there are too many red blood cells in the bone marrow and blood, causing the blood to thicken. The number of white blood cells and platelets may also increase.

What is secondary Evans syndrome?

Evans syndrome is an autoimmune condition that presents with two or more cytopenias, which commonly includes autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP), with or without immune neutropenia. It can be primary (or idiopathic) or secondary (i.e., associated with an underlying disorder).

What causes Heinz body formation?

Heinz bodies are the result of oxidative damage to erythrocyte hemoglobin. They may be seen in conjunction with eccentrocytes, which are the result of oxidative damage to the erythrocyte membrane. Heinz body formation is a cause of hemolytic anemia.

What causes Heinz bodies in G6PD deficiency?

G6PD deficient red cells in combination with high levels of oxidants causes a cross-linking of sulfhydryl groups on globin chains which causes a denaturing and formation of Heinz body precipitates. Heinz bodies can also be found in chronic liver disease.

How is aplastic anemia diagnosed?

To diagnose aplastic anemia, physicians must examine the cells of the bone marrow and blood under a microscope. To do this, they will likely perform blood and laboratory tests as well as a bone marrow aspiration and biopsy.