Neutrophilic erythrophagocytosis in a child with paroxysmal cold hamoglobinuria

[摘要] A 3-year-old previously healthy male child presented to the emergencydepartment with a 2-day history of fatigue, jaundice, and dark-browncolored urine following a week of vomiting and fever. There was nosignificant past medical, drug or family history. Clinical examinationwas normal apart from jaundice and mildly enlarged spleen on physical examination, confirmed on ultrasonography. Blood tests revealed hemoglobin of 57 g/L, haptoglobin of <0.2 g/L bilirubin of 80 µmol/L,lactate dehydrogenase of 1902 U/L, and C-reactive peptide of 126mg/L. Direct antiglobulin test was strongly positive for C3d only.