PT  - JOURNAL ARTICLE
AU  - Jennifer Delun Williams
AU  - Ram K Jayaprakash
AU  - Heena Kithany
AU  - Mark Peter Tighe
TI  - How to use Donath-Landsteiner test to diagnose paroxysmal cold haemoglobinuria (PCH)
AID  - 10.1136/archdischild-2020-319568
DP  - 2022 Jun 01
TA  - Archives of disease in childhood - Education & practice edition
PG  - 199--206
VI  - 107
IP  - 3
4099  - http://ep.bmj.com/content/107/3/199.short
4100  - http://ep.bmj.com/content/107/3/199.full
SO  - Arch Dis Child Educ Pract Ed2022 Jun 01; 107
AB  - Paroxysmal cold haemoglobinuria (PCH) accounts for around a third of cases of autoimmune haemolytic anaemia in children. PCH is caused by an autoantibody that fixes complement to red cells at low temperatures and dissociates at warmer temperatures (a biphasic haemolysin), triggering complement-mediated intravascular haemolysis. Named the Donath-Landsteiner (D-L) antibody after its discoverers, it is usually formed in response to infection and demonstrates specificity for the ubiquitous red cell P-antigen. A D-L test can be used to detect the presence of the D-L autoantibody in the patients’ serum. Here we discuss the use of the D-L test in identifying PCH in a 2-year-old boy who presented with haemolytic anaemia. A summary of the key information can be found in the infographic.