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Lederer's Anemia Accompanying Urinary Tract Infection: Report of a Case, with a Note on the Diagnostic Use of Haptoglobin Determination

Lederer's Anemia Accompanying Urinary Tract Infection: Report of a Case, with a Note on the... Abstract Acquired hemolytic anemia may present as a fulminating and toxic illness with an acute onset. This syndrome, most frequently encountered in children, was initially described by Chauffard and Vincent1 and later emphasized by Lederer,2,3 whose name has become associated with it. With the advent of modern serological and biochemical techniques it has been shown that a variety of underlying disorders may produce this syndrome. The present case of acute acquired hemolytic anemia occurred in conjunction with an Escherichia coli urinary tract infection. Cessation of the hemolytic process was demonstrated to coincide with the introduction of appropriate antibiotic therapy, and a causal relationship between the urinary tract infection and hemolysis is strongly suggested by the data. In addition, evaluation of the hemoglobin-binding capacity of the patient's serum by means of starch gel electrophoresis proved to be a valuable test for acute hemolysis and hemoglobinuria. Report of Case A 3-year-old References 1. Chauffard, M. A., and Vincent, C.: Hémoglobinurie hémolysinique avec ictére polycholique aigu , Semaine méd . 29:601-604 ( (Dec. 22) ) 1909. 2. Lederer, M.: A Form of Acute Hemolytic Anemia, Probably of Infectious Origin , Am. J.M. Sc. 170:500-501 ( (Oct.) ) 1925.Crossref 3. Lederer, M.: Three Additional Cases of Acute Hemolytic (Infectious) Anemia , Am. J.M. Sc. 179:228-236 ( (Feb.) ) 1930.Crossref 4. Smithies, O.: Zone Electrophoresis in Starch Gels: Group Variations in the Serum Proteins of Normal Human Adults , Biochem. J. 61:629-641 ( (Dec.) ) 1955. 5. Allison, A. C., and ap Rees, W.: The Binding of Haemoglobin by Plasma Proteins , Brit. M.J. 2:1137-1142 ( (Nov. 16) ) 1957.Crossref 6. Laurell, C-B., and Nyman, M.: Studies on the Serum Haptoglobin Level in Hemoglobinemia and Its Influence on Renal Excretion of Hemoglobin , Blood 12:493-506 ( (June) ) 1957. 7. Nosslin, B. F., and Nyman, M.: Haptoglobin Determination in the Diagnosis of Haemolytic Disease , Lancet 1:1000-1001 ( (May 10) ) 1958.Crossref 8. Javid, J.; Horowitz, H. I.; Sanders, A. R., and Spaet, T. H.: Idiopathic Paroxysmal Myoglobinuria: Report of a Case with Studies on Serum Haptoglobin Levels , A.M.A. Arch. Int. Med. 104:628-633 ( (Oct.) ) 1959.Crossref 9. Javid, J.; Fischer, D. S., and Spaet, T. H.: Inability of Haptoglobin to Bind Myoglobin , Blood 14:683-687 ( (June) ) 1959. 10. Millichap, J. G.: Acute Idiopathic Hemolytic Anemia , Arch. Dis. Childhood 27:222 ( (June) ) 1952.Crossref 11. Dacie, J. V.: The Haemolytic Anaemias, Congenital and Acquired , New York, Grune & Stratton, Inc., 1954. 12. Todd, R., and O'Donohoe, N. V.: Acute Acquired Hemolytic Anemia Associated with Herpes Simplex Infection , Arch. Dis. Childhood 33:524 ( (Dec.) ) 1958.Crossref 13. Payne, R.; Spaet, T. H., and Aggeler, P. M.: An Unusual Antibody Pattern in a Case of Idiopathic Acquired Hemolytic Anemia , J. Lab. & Clin. Med. 46:245-254 ( (Aug.) ) 1955. 14. Chorpenning, F. W., and Hayes, J. C.: Occurrence of the Thomsen-Friedenreich Phenomenon in Vivo , Vox sang . 4:210-224 ( (July) ) 1959. 15. Daland, G. A.; Gottlieb, L.; Wallerstein, R. O., and Castle, W. B.: Hematological Observations in Bacterial Endocarditis , J. Lab. & Clin. Med. 48:827-845 ( (Dec.) ) 1956. 16. Hargraves, M. M.; Herrell, W. E., and Pearman, R. O.: Erythrophagocytic Anemia (Lederer's Anemia?): Report of a Case with Recovery , Proc. Staff Meet. Mayo Clin. 16:107-112 ( (Feb. 12) ) 1941. 17. Zinkham, W. H., and Diamond, L. K.: In Vitro Erythrophagocytosis in Acquired Hemolytic Anemia , Blood 7:592-601 ( (June) ) 1952. 18. Burnet, F. M.; McCrea, J. F., and Stone, J. D.: Modification of Human Red Cells by Virus Action: I. The Receptor Gradient for Virus Action in Human Red Cells , Brit. J. Exper. Path. 27: 228-286 ( (Aug.) ) 1946. 19. Hoyt, R. E., and Zwicker, H.: The Role of Enzyme in Reversible Agglutination of Red Cells , J. Immunol. 71:325-330 ( (Nov.) ) 1953. 20. Smith, M. J., and Spaet, T. H.: Studies on the Normal Serum Panagglutinin Active Against Trypsinated Human Erythrocytes: IV. The Presence of Normal Serum Panagglutinin in Patients with Congenital Agammaglobulinemia , J. Lab. & Clin. Med. 52:645-647 ( (Oct.) ) 1958. 21. Ho, M., and Kass, E. H.: Hemolytic Anemia in Rabbits Following Injection of Bacterial Endotoxin , Proc. Soc. Exper. Biol. & Med. 97:505-509 ( (March) ) 1958. 22. Gortstein, F., and Benacerraf, B.: Experimental "Hypersplenism" Induced by Repeated Injections of Zymosan , Federation Proc . 18:478 ( (March) ) 1959. 23. Dern, R. J.; Beutler, E., and Alving, A. S.: The Hemolytic Effect of Primaquine: V. Primaquine Sensitivity as a Manifestation of a Multiple Drug Sensitivity , J. Lab. & Clin. Med. 45:30-39 ( (Jan.) ) 1955. 24. Fikrig, S.: Erythrocyte Glucose-6-Phosphate-Dehydrogenase Activity and Anemia Due to Infection, Abstract, Program of the Society for Pediatric Research, 29th Annual Meeting, Buck Hill Falls, Pa., May 8-9, 1959, p. 27 25. A.M.A.J. Dis. Child. 98:583 ( (Nov.) ) 1959. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

Lederer's Anemia Accompanying Urinary Tract Infection: Report of a Case, with a Note on the Diagnostic Use of Haptoglobin Determination

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American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1960.02070030759010
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Abstract

Abstract Acquired hemolytic anemia may present as a fulminating and toxic illness with an acute onset. This syndrome, most frequently encountered in children, was initially described by Chauffard and Vincent1 and later emphasized by Lederer,2,3 whose name has become associated with it. With the advent of modern serological and biochemical techniques it has been shown that a variety of underlying disorders may produce this syndrome. The present case of acute acquired hemolytic anemia occurred in conjunction with an Escherichia coli urinary tract infection. Cessation of the hemolytic process was demonstrated to coincide with the introduction of appropriate antibiotic therapy, and a causal relationship between the urinary tract infection and hemolysis is strongly suggested by the data. In addition, evaluation of the hemoglobin-binding capacity of the patient's serum by means of starch gel electrophoresis proved to be a valuable test for acute hemolysis and hemoglobinuria. Report of Case A 3-year-old References 1. Chauffard, M. A., and Vincent, C.: Hémoglobinurie hémolysinique avec ictére polycholique aigu , Semaine méd . 29:601-604 ( (Dec. 22) ) 1909. 2. Lederer, M.: A Form of Acute Hemolytic Anemia, Probably of Infectious Origin , Am. J.M. Sc. 170:500-501 ( (Oct.) ) 1925.Crossref 3. Lederer, M.: Three Additional Cases of Acute Hemolytic (Infectious) Anemia , Am. J.M. Sc. 179:228-236 ( (Feb.) ) 1930.Crossref 4. Smithies, O.: Zone Electrophoresis in Starch Gels: Group Variations in the Serum Proteins of Normal Human Adults , Biochem. J. 61:629-641 ( (Dec.) ) 1955. 5. Allison, A. C., and ap Rees, W.: The Binding of Haemoglobin by Plasma Proteins , Brit. M.J. 2:1137-1142 ( (Nov. 16) ) 1957.Crossref 6. Laurell, C-B., and Nyman, M.: Studies on the Serum Haptoglobin Level in Hemoglobinemia and Its Influence on Renal Excretion of Hemoglobin , Blood 12:493-506 ( (June) ) 1957. 7. Nosslin, B. F., and Nyman, M.: Haptoglobin Determination in the Diagnosis of Haemolytic Disease , Lancet 1:1000-1001 ( (May 10) ) 1958.Crossref 8. Javid, J.; Horowitz, H. I.; Sanders, A. R., and Spaet, T. H.: Idiopathic Paroxysmal Myoglobinuria: Report of a Case with Studies on Serum Haptoglobin Levels , A.M.A. Arch. Int. Med. 104:628-633 ( (Oct.) ) 1959.Crossref 9. Javid, J.; Fischer, D. S., and Spaet, T. H.: Inability of Haptoglobin to Bind Myoglobin , Blood 14:683-687 ( (June) ) 1959. 10. Millichap, J. G.: Acute Idiopathic Hemolytic Anemia , Arch. Dis. Childhood 27:222 ( (June) ) 1952.Crossref 11. Dacie, J. V.: The Haemolytic Anaemias, Congenital and Acquired , New York, Grune & Stratton, Inc., 1954. 12. Todd, R., and O'Donohoe, N. V.: Acute Acquired Hemolytic Anemia Associated with Herpes Simplex Infection , Arch. Dis. Childhood 33:524 ( (Dec.) ) 1958.Crossref 13. Payne, R.; Spaet, T. H., and Aggeler, P. M.: An Unusual Antibody Pattern in a Case of Idiopathic Acquired Hemolytic Anemia , J. Lab. & Clin. Med. 46:245-254 ( (Aug.) ) 1955. 14. Chorpenning, F. W., and Hayes, J. C.: Occurrence of the Thomsen-Friedenreich Phenomenon in Vivo , Vox sang . 4:210-224 ( (July) ) 1959. 15. Daland, G. A.; Gottlieb, L.; Wallerstein, R. O., and Castle, W. B.: Hematological Observations in Bacterial Endocarditis , J. Lab. & Clin. Med. 48:827-845 ( (Dec.) ) 1956. 16. Hargraves, M. M.; Herrell, W. E., and Pearman, R. O.: Erythrophagocytic Anemia (Lederer's Anemia?): Report of a Case with Recovery , Proc. Staff Meet. Mayo Clin. 16:107-112 ( (Feb. 12) ) 1941. 17. Zinkham, W. H., and Diamond, L. K.: In Vitro Erythrophagocytosis in Acquired Hemolytic Anemia , Blood 7:592-601 ( (June) ) 1952. 18. Burnet, F. M.; McCrea, J. F., and Stone, J. D.: Modification of Human Red Cells by Virus Action: I. The Receptor Gradient for Virus Action in Human Red Cells , Brit. J. Exper. Path. 27: 228-286 ( (Aug.) ) 1946. 19. Hoyt, R. E., and Zwicker, H.: The Role of Enzyme in Reversible Agglutination of Red Cells , J. Immunol. 71:325-330 ( (Nov.) ) 1953. 20. Smith, M. J., and Spaet, T. H.: Studies on the Normal Serum Panagglutinin Active Against Trypsinated Human Erythrocytes: IV. The Presence of Normal Serum Panagglutinin in Patients with Congenital Agammaglobulinemia , J. Lab. & Clin. Med. 52:645-647 ( (Oct.) ) 1958. 21. Ho, M., and Kass, E. H.: Hemolytic Anemia in Rabbits Following Injection of Bacterial Endotoxin , Proc. Soc. Exper. Biol. & Med. 97:505-509 ( (March) ) 1958. 22. Gortstein, F., and Benacerraf, B.: Experimental "Hypersplenism" Induced by Repeated Injections of Zymosan , Federation Proc . 18:478 ( (March) ) 1959. 23. Dern, R. J.; Beutler, E., and Alving, A. S.: The Hemolytic Effect of Primaquine: V. Primaquine Sensitivity as a Manifestation of a Multiple Drug Sensitivity , J. Lab. & Clin. Med. 45:30-39 ( (Jan.) ) 1955. 24. Fikrig, S.: Erythrocyte Glucose-6-Phosphate-Dehydrogenase Activity and Anemia Due to Infection, Abstract, Program of the Society for Pediatric Research, 29th Annual Meeting, Buck Hill Falls, Pa., May 8-9, 1959, p. 27 25. A.M.A.J. Dis. Child. 98:583 ( (Nov.) ) 1959.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Jun 1, 1960

References