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October 17, 1980

Acute Renal Failure, Hemolytic Anemia, and Mycoplasma pneumoniae

Author Affiliations

From the Department of Medicine, St Elizabeth's Hospital, and Tufts University School of Medicine, Boston. Dr Schulman is now with the Division of Cardiology, Department of Medicine, University of South Florida College of Medicine, and the Veterans Administration Hospital, Tampa.

JAMA. 1980;244(16):1823-1824. doi:10.1001/jama.1980.03310160039023

FULMINANT intravascular hemolysis is a well-described complication of Mycoplasma pneumoniae infection.1 While the majority of patients with this disease may have raised cold hemagglutinin titers, severe hemolytic anemia is a relatively rare sequela.1 The present communication describes a Mycoplasma infection in a patient in whom severe hemolysis and acute reversible renal failure developed.

Report of a Case  A 49-year-old woman with no known preexisting renal disease was well until six days before admission, when a productive, hacking cough developed for which she was given penicillin G potassium, 250 mg four times daily. When no improvement was noted two days later, she was given tetracycline hydrochloride, 250 mg four times daily. On the following day, she was noted to be jaundiced and confused and was admitted to her local hospital. Initial studies disclosed hematocrit value of 16%; BUN level, 58 mg/dL; creatinine level, 1.8 mg/dL; total bilirubin concentration, 5.5