ISSN 1302-9940 | e-ISSN 1308-8491

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The Journal of the Child Mikoplazma Pnmonisine bal souk agltinin hastal; sk grlen hastaln az grlen komplikasyonu. [J Child]
J Child. 2019; 19(2): 100-104 | DOI: 10.5222/j.child.2019.67044

Mikoplazma Pnmonisine bal souk agltinin hastal; sk grlen hastaln az grlen komplikasyonu.

Erdem Gnll1, Ahmet Soysal2, Atila Tanyeli3, Blent Karada4, Metin Karabcolu1
1Memorial Ataehir Hastanesi, Pediatri Klinii, stanbul
2Memorial Ataehir Hastanesi, Pediatrik Enfeksiyon Hastalklar Klinii, stanbul
3Memorial ili Hastanesi, Pediatrik Hematoloji Ve Onkoloji Klinii, stanbul
4Marmara niversitesi Tp Fakltesi, Pediatrik Gs Hastalklar Bilim Dal, stanbul

14 yanda kz hasta 3 gndr sren yksek ate ve ksrk ikayeti ile bavurdu. Yaknmalar baladktan sonra oseltamivir kullanmaya balad renildi. Fizik incelemesinde sol akcier alt ve orta zonlarda solunum seslerinde azalma ve sa akcierde krepitan ralleri mevcut idi. Laboratuar incelemesinde Hemoglobin 10,6 g/dL, Hematokrit %33.5, MCV 76,5 fL, beyaz kre says 5,97 bin /uL, trombosit says 180 bin/uL, CRP 205,6 mg/L, prokalsitonin 1,28 ing/mL idi. PA akcier grafisinde sol akcier orta ve alt zonlarnda lober konsolidasyon, sa akcier alt zonda infiltrasyon ile uyumlu grnt mevcut idi. Hastaya seftriakson, klaritromisin ve teikoplanin tedavileri baland. Tedavinin 3. gnnde atei dt. Genel durumu dzeldi. Tedavinin 10. gn ekilen PA akcier grafi bulgular belirgin dzeldi ancak alnan kontrol tetkiklerinde Hemoglobini 10,8 g/dL, Hematokrit %20,6, trombosit says 519 bin/uL olarak bulundu. Hastann retiklositi % 2,14 Direkt ve indirekt Coombs testi pozitif bulundu. Souk Agglutinin titrasyon testi 1/2016, Kriyoglobulin negatif, Kriyofibrinojen negatif bulundu. Mycoplasma pneumoniae (M. pneumoniae) IgM 1,33 (pozitif), M. pneumoniae IgG 0,38 (negatif), EBV - VCA IgM: 0,62 (negatif), EBV - VCA IgG: 196 (pozitif) bulundu. Hasta klinik olarak izlendi. Ek bir tedavi verilmeden hasta levofloksasin tedavisi ile taburcu edildi. zleminde hemoliz krizi tekrar gzlenmedi.

Sonu: Akcier enfeksiyonu geiren hastalarda hemoglobin hematokrit uyumazl saptandnda souk agglutinasyon hastal akla getirilmelidir.

Anahtar Kelimeler: Mycoplasma pneumoniae, souk agltinin, hemolitik anemi.

Cold agglutinin disease due to Mycoplasma pneumonia; uncommon complication of common disease.

Erdem Gnll1, Ahmet Soysal2, Atila Tanyeli3, Blent Karada4, Metin Karabcolu1
1Memorial Ataehir Hospital, Department of Pediatrics, stanbul
2Memorial Ataehir Hospital, Department of Pediatric Infectious Diseases, stanbul
3Memorial ili Hospital, Department of Pediatric Hematology and Oncology, stanbul
4Marmara University School of Medicine, Department of Pediatric Pulmonology, stanbul

A 14-year-old female patient presented with a 3-day history of high fever and cough. She had oseltamivir after her complaints started. Physical examination revealed decreased breath sounds in the lower and middle zones of the left lung and crepitant rales in the right lung. In the laboratory examination, hemoglobin 10.6 g / dL, hematocrit 33.5%, MCV 76.5 fL, white blood cell count 5.97 thousand / uL, platelet count 180 thousand / uL, CRP 205.6 mg / L, procalcitonin 1.28 ing / mL found. PA chest X-ray showed consolidation in the middle and lower zones of the left lung and infiltration in the lower zone of the right lung. Ceftriaxone, clarithromycin and teicoplanin were started. On the third day of treatment, fever was decreased and her general condition improved. On the 10th day of clinical follow-up, the chest X-ray findings improved significantly, but hemoglobin level was decreased to 10.8 g / dL and hematocrit 20.6%, platelet count 519 thousand / uL, and reticulocyte count found 2.14%, respectively. Direct and indirect Coomb were positive. Cold Agglutinin titration test found 1/2016, Cryoglobulin negative, Cryofibrinogen negative. Mycoplasma pneumoniae (M. pneumoniae) IgM 1.33 (positive), M. pneumoniae IgG 0.38 (negative), EBV - VCA IgM: 0.62 (negative), EBV - VCA IgG: 196 (positive). She was discharged with levofloxacin treatment without any additional treatment. No hemolysis crisis was observed during the follow-up.

Conclusion: Cold agglutination disease should be considered when hemoglobin - hematocrit incompatibility is detected in patients with lung infection

Keywords: Mycoplasma pneumoniae, cold agglutinin, hemolytic anemia.

Erdem Gnll, Ahmet Soysal, Atila Tanyeli, Blent Karada, Metin Karabcolu. Cold agglutinin disease due to Mycoplasma pneumonia; uncommon complication of common disease.. J Child. 2019; 19(2): 100-104

Sorumlu Yazar: Erdem Gnll, Trkiye
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