1988 Volume 2 Issue 4 Pages 400-405
A case of paroxysmal cold hemoglobinuria (PCH) was described, occurring in a 26-month old boy without a history of any previous infection and serologically negative for syphilis. After the patient was brought to a physician because of a fever and dark urine after exposure to cold weather over again, his anemia and hemoglobinuria were pointed out. He was admitted to the Department of Pediatrics, Hirosaki University School of Medicine, for further examination. Laboratory evaluation on admission revealed anemia and a high value of LDH. Direct Coombs test was negative ; the cold agglutinin activity was of low titer. Sugar water test was negative. Since Donath-Landsteiner (DL) test had been positive, Ehrlich finger test positive, and DL antibody positive, the patient was diagnosed as having PCH. Fragility of the patient's erythrocytes after cooling was demonstrated using Coil Planet Centrifuge. After the admission, his hemolytic attack disappeared by keeping warm. He was discharged on the 48th day of illness and DL antibody became negative on the 137th day of illness.
