Case Study: Acute Cytomegalovirus Infection Leading to Severe Mixed Autoimmune Hemolytic Anemia in an Immunocompetent Individual
By
Junjie Hou
Yanhong Ding
Huiyao Chen
Min Liao
Chun Feng
Jihao Zhou
Guoqiang Li
Peng Ke
Feichang Du
September 15, 2026
Clinical Scorecard: Case Study: Acute Cytomegalovirus Infection Leading to Severe Mixed Autoimmune Hemolytic Anemia in an Immunocompetent Individual
At a Glance
Category Detail
Condition Cytomegalovirus-associated mixed autoimmune hemolytic anemia Key Mechanisms Involves simultaneous warm-reactive IgG and cold-reactive IgM autoantibodies leading to hemolysis. Target Population Immunocompetent adults Care Setting Hospitalized patients with acute CMV infection
Key Highlights
Severe mixed AIHA is rare in immunocompetent individuals. Diagnosis requires comprehensive immunohematologic testing beyond routine DAT. Combination therapy effectively managed severe hemolysis. CMV infection can lead to significant hematologic complications. Early integrated treatment is crucial for severe cases. Guideline-Based Recommendations
Diagnosis
Utilize comprehensive immunohematologic assessment including extended DAT and cold agglutinin testing. Management
Administer antiviral therapy alongside immunomodulatory and supportive treatments. Monitoring & Follow-up
Regularly assess hemoglobin levels and signs of hemolysis. Risks
Severe mixed AIHA may necessitate transfusion support and can be misclassified. Patient & Prescribing Data
Immunocompetent adults with acute CMV infection and severe mixed AIHA.
Ganciclovir was administered intravenously, and supportive care was provided.
Clinical Best Practices
Conduct thorough serologic testing to confirm mixed AIHA. Initiate treatment promptly in cases of severe hemolysis. Monitor for complications associated with CMV infection. Related Resources & Content
