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August 22, 1977

Hemolytic Anemia With Mycoplasma Pneumoniae Pneumonia

JAMA. 1977;238(8):854. doi:10.1001/jama.1977.03280090018008

To the Editor.—  We read with interest the article by Turtzo and Ghatak, "Acute Hemolytic Anemia With Mycoplasma Pneumoniae Pneumonia (236:1140, 1976).In our view there are serious questions regarding the type of autoantibody causing hemolysis in the patient presented.Although the direct Coombs' test was positive, no attempts were made to use monospecific Coombs' sera (anti-IgG, anti-C') to characterize the red cell surface proteins. In addition, there were no attempts to elute an antibody from the patient's cells. These determinations are critical if one hopes either to classify the antibody causing hemolysis or to identify it specifically.The indirect Coombs' test revealed both anti-c and anti-e activity. If these antibodies were indeed present and are assumed to be alloantibodies, the patient's Rh phenotype would be CCdEE or CCDEE. Both phenotypes are quite uncommon (in a white population, less than 1/100,000).1 To resolve this problem, the patient's phenotype should