Significance of Donath-Landsteiner Antibody Test for Diagnoses of a Rare Case of Paroxysmal Cold Hemoglobinuria with Acute Renal Failure

Donath Landsteiner (DL) antibodies are biphasic IgG autoantibodies formed in response to a viral or bacterial infection and can induce paroxysmal cold hemoglobinuria (PCH), an autoimmune hemolytic anaemia. It is more frequently seen in children post-infective episodes and is transient and self-limiting in nature. We report a case of a 4.5-year-old male who presented with sudden intravascular hemolysis and AKI with a 2-weekold history of fever and acute viral hepatitis. AKI in PCH is a rarity, and the diagnoses of PCH could only be made correctly with the help of a DL antibody test, which helped with subsequent patient management and avoiding unnecessary treatment escalation.