Combined cold- and warm-antibody autoimmune hemolytic anemia--review of the literature and a case report.

This report described the second case in the literature of Waldenstrom's macroglobulinemia with combined cold- and warm- antibody autoimmune hemolytic anemia (CCW-AIHA). Both IgG and IgM red cell auto-antibodies (auto-Abs) were present in the patient's serum. The IgM auto-Abs had a high thermal amplitude and anti-I blood group specificity. The IgG auto-Abs did not reveal blood group specificity. This patient depended on steroids to control hemolysis, but responded well to chemotherapy and plasmapheresis. CCW-AIHA has rarely been reported. In this study, the literature is reviewed and the characteristic serological and clinical features of this rare category of autoimmune hemolytic anemia (AIHA) are discussed.