title: [Paroxysmal cold hemoglobinuria: only in the textbooks?].
abstract: Although it was common in the preantibiotic era, paroxysmal cold hemoglobinuria (PCH) is now an exceptional condition. A 34-year-old female with anemia and episodic hemoglobinuria provoked by cold is reported. The laboratory studies suggested intravascular hemolytic anemia, and the Donath-Landsteiner test showed a biphasic IgG hemolysin with anti-P specificity. This finding and the evidence of latent syphilis were diagnostic of PCH. Penicillin therapy suppressed the hemolytic episodes, although the Donath-Landsteiner test is still positive. It is concluded that PCH is still an exisiting disease which should be considered in the differential diagnosis of episodic hemoglobinuria.
authors.affiliation: Servicio de Hematología Clínica, Hospital Clínic i Provincial, Barcelona.
authors.forename: L
authors.initials: L
authors.lastname: Escoda
authors.forename: A
authors.initials: A
authors.lastname: Pereira
authors.forename: A
authors.initials: A
authors.lastname: Graena
authors.forename: J L
authors.initials: JL
authors.lastname: Vives-Corrons
authors.forename: C
authors.initials: C
authors.lastname: Rozman
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000175:diagnosis; D003080:Cold Temperature / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D010402:Penicillin G Procaine / Q000627:therapeutic use; D013592:Syphilis, Latent / Q000150:complications / Q000188:drug therapy
chemical_list: D010402:Penicillin G Procaine
vernacular_title: Hemoglobinuria paroxística a frigore: sólo en los libros de texto?