Paroxysmal cold hemoglobinuria in a child with RSV: an underrecognized cause of hemolytic anemia

Paroxysmal cold hemoglobinuria (PCH) is an often underrecognized autoimmune hemolytic anemia that requires a high index of suspicion and specialized testing for diagnosis. It can present with life-threatening anemia in children following a viral illness. We present the case of a previously healthy boy found to have respiratory syncytial virus (RSV) and severe anemia due to PCH. This case report will highlight key features that may raise clinical suspicion for this diagnosis and provide guidance for diagnostic testing and management.