Case Report: Severe mixed autoimmune hemolytic anemia associated with acute cytomegalovirus infection in an immunocompetent adult - Takeaways - MDSpire
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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

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  • 1

    Cytomegalovirus (CMV)-associated hemolytic anemia (HA) is rare in immunocompetent individuals and can present as mixed autoimmune hemolytic anemia (AIHA).

  • 2

    A 59-year-old man developed severe CMV-associated mixed AIHA after presenting with fever, sore throat, and fatigue, confirmed by comprehensive immunohematologic testing.

  • 3

    The patient exhibited significant laboratory findings, including a hemoglobin level of 40 g/L and evidence of acute hemolysis, alongside positive CMV IgM and negative IgG.

  • 4

    Diagnosis of mixed AIHA requires extensive testing, including extended direct antiglobulin test (DAT) and cold agglutinin titration, beyond routine DAT.

  • 5

    The patient's severe mixed AIHA was managed successfully with antiviral therapy and immunomodulatory treatment, stabilizing hemoglobin without further transfusions.

Original Source(s)

Case Report: Severe mixed autoimmune hemolytic anemia associated with acute cytomegalovirus infection in an immunocompetent adult

  • by Junjie Hou, Yanhong Ding, Huiyao Chen, Min Liao, Chun Feng, Jihao Zhou, Guoqiang Li, Peng Ke, Feichang Du

  • September 15, 2026

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