Cold agglutinin disease in a patient with Legionnaires' disease.

We present a case of Legionnaires' disease complicated by cold agglutinin disease. Therapy with erythromycin gluceptate was associated with resolution of both the pneumonia and the hemolysis. Complement-fixing antibody levels to Mycoplasma pneumoniae, influenza A, and adenoviruses were measured repeatedly throughout the clinical illness and were persistently nondiagnostic. The cold agglutinin present in the patient's serum was characterized as an IgM that demonstrated anti-I specificity. Thus, Legionella pneumophila should be considered a potential causative agent in patients with pneumonia and cold agglutinin disease.

[1]  B. Forget,et al.  Hemolytic anemias: congenital and acquired. , 1980, Hospital practice.

[2]  C. Watanakunakorn,et al.  Hospital-acquired fungemia. Its natural course and clinical significance. , 1979, The American journal of medicine.

[3]  G. Grady,et al.  Relation of Mycoplasma pneumoniae seroreactivity, immunosuppression, and chronic disease to Legionnaires' disease. A twelve-month prospective study of sporadic cases in Massachusetts. , 1979, Annals of internal medicine.

[4]  J. Sanford.  Legionnaires' disease--the first thousand days. , 1979, The New England journal of medicine.

[5]  H. Wilkinson,et al.  Indirect immunofluorescence test for serodiagnosis of Legionnaires disease: evidence for serogroup diversity of Legionnaires disease bacterial antigens and for multiple specificity of human antibodies , 1979, Journal of clinical microbiology.

[6]  S. Finegold,et al.  Legionnaires' disease: clinical features of 24 cases. , 1978, Annals of internal medicine.

[7]  W. W. Rhodes,et al.  Pontiac fever. An epidemic of unknown etiology in a health department: I. Clinical and epidemiologic aspects. , 1978, American journal of epidemiology.

[8]  W. Pruzanski,et al.  Biologic Activity of Cold-Reacting Autoantibodies , 1977 .

[9]  D. Smith,et al.  Fever of unknown origin secondary to brewer's yeast ingestion. , 1976, Archives of internal medicine.

[10]  P. Dowling,et al.  An Incomplete Cold‐Reactive γG Antibody with i Specificity in Infectious Mononucleosis 1 , 1969 .

[11]  W. Marsh,et al.  Anti‐Sp1: The Recognition of a New Cold Auto‐Antibody , 1968, Vox sanguinis.

[12]  J. Grayston,et al.  EATON PLEUROPNEUMONIA-LIKE ORGANISM (MYCOPLASMA PNEUMONIAE) COMPLEMENT-FIXING ANTIGEN: EXTRACTION WITH ORGANIC SOLVENTS. , 1965, Journal of immunology.

[13]  H. Francis,et al.  Trends in home nursing: the Birmingham Service 1950-57. , 1959, Lancet.

[14]  P. Charlwood.  Ultracentrifugal Studies on Sera Containing Cold Haemagglutinins , 1957 .

[15]  A. S. Wiener,et al.  Type-specific cold auto-antibodies as a cause of acquired hemolytic anemia and hemolytic transfusion reactions: biologic test with bovine red cells. , 1956, Annals of internal medicine.

[16]  M. Finland,et al.  COLD AGGLUTININS (AUTOHEMAGGLUTININS) IN PRIMARY ATYPICAL PNEUMONIAS. , 1943, Science.

[17]  H. Schubothe.  The cold hemagglutinin disease. , 1966, Seminars in hematology.