[A case of paroxysmal cold hemoglobinuria (PCH) in the elderly found by severe anemia].
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.
Saito
M
M
3rd Department of Internal Medicine, Yokohama City University.
Endo
O
O
Okazaki
H
H
Inoue
S
S
Takamura
Y
Y
Watanabe
S
S
D000368:Aged; D000740:Anemia / Q000209:etiology; D003080:Cold Temperature; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications / Q000175:diagnosis*; D006801:Humans