title: [A case of paroxysmal cold hemoglobinuria (PCH) in the elderly found by severe anemia].
abstract: 69 year-old female. Two weeks before the admission, the patient had suffered from upper respiratory tract infection. Severe anemia was detected (Hb was 6.0 mg/dl) and she received a transfusion. Four days after the transfusion, she became icteric and was transferred to our hospital on Feb. 3, 1990 for evaluation of anemia. Laboratory data on admission are as follows; Hb 6.3 g/dl, reticulocytes 128%, total bilirubin 4.6 mg/dl, indirect bilirubin 3.4 mg/dl, urobilinogen in urine positive, WR negative, direct anti-globulin test positive, indirect of the test negative, and Donath-Landsteiner test positive (both direct and indirect). Her red blood cells were classified as P2-positive. From these findings, non-syphilitic PCH was diagnosed. She required bed rest and therapy to protect her from cold exposure. The hemoglobin recovered to 8.3 g/dl. The D-L test was positive for 9 months. This is a rare case of PCH because the patient fell ill in old age and PCH was found because of her severe anemia in spite of her unawareness of hemoglobinuria.
authors.affiliation: 3rd Department of Internal Medicine, Yokohama City University.
authors.forename: M
authors.initials: M
authors.lastname: Saito
authors.forename: O
authors.initials: O
authors.lastname: Endo
authors.forename: H
authors.initials: H
authors.lastname: Okazaki
authors.forename: S
authors.initials: S
authors.lastname: Inoue
authors.forename: Y
authors.initials: Y
authors.lastname: Takamura
authors.forename: S
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D000740:Anemia / Q000209:etiology; D003080:Cold Temperature; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications / Q000175:diagnosis*; D006801:Humans