Autoimmune hemolytic anemia in Wiskott-Aldrich syndrome during treatment with transfer factor

Two children with Wiskott-Aldrich syndrome were treated with multiple doses of dialyzed transfer factor. A positive Coombs test develped after the first course of therapy in one patient. During the second course of therapy, a severe autoimmune hemolytic anemia occurred concomitant with a Coxsackie B infection. Review of the Wiskott-Aldrich syndrome reveals an unexpectedly high incidence of antiglubulin-positive hemolytic anemia. Prior to therapy both patients lacked delayed skin hypersensitivity and had poor or absent in vitro responses of lymphocytes to allogenic cells and to specific antigens. Conversion of mixed leukocyte culture reactivity represents new evidence which seems to indicate that transfer factor exerts a nonspecific influence on cellular immune function. The relationship of the autoimmune hemolytic anemia in the one patient to the altered immunologic capacity following treatment with transfer factor is discussed.