A Case of T-polyagglutination Accompanied with Meningitis due to Streptococcus pneumoniae

Polyagglutination of red blood cells was observed in a 1 year and 8 month old boy, who was admitted for complaints of fever, impaired conciousness and paralysis of right sided-extremities, associated with meningitis due to Streptococcus pneumoniae. In immunological and hematological findings, patient's red cells showed potent agglutination with most of normal human sera except those of newborn infants. T-polyagglutination of red cells was identified by agglutination using several plant lectins, the agglutination with Arachis hypogaea showing the most potent titer of 1: 2056. Anti-T antibody had not been detected on admission but reappeared 10 days later, at which red cells returned to normal. This phenomenon is known to occur in patients with severe infectious diseases. In Japan, three cases of T-polyagglutination have been reported until now and all of these cases were found by discrepancy between forward and reverse ABO blood groupings. The T-polyagglutination of red cells in our case was detected only by minor crossmatching incompatibility. This case accompanied marked thrombocytopenia in absence of hemolytic anemia but it remained uncertain whether thrombocytopenia was related to T-polyagglutination.