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December 10, 1960

Paroxysmal Cold HemoglobinuriaApparent Remission After Splenectomy

Author Affiliations

New Orleans

From the Internal Medicine Department, Charity Hospital of Louisiana at New Orleans, and the Louisiana State University School of Medicine. Dr. Banov is now a clinical Fellow in the Department of Medicine, Massachusetts General Hospital, Boston.

JAMA. 1960;174(15):1974-1975. doi:10.1001/jama.1960.63030150007020a

Paroxysmal cold hemoglobinuria is not a common disease. In more than 500,000 patients over a 20-year period at the University of Chicago Clinics, Becker1 reported only one case of this disease. Mackenzie2 reviewed the history of the disorder and noted that it was partially observed as early as 1794. Dressler differentiated hemoglobinuria from hematuria in 1854. In 1880, Rosenback noted that hemoglobinuria could be produced in affected individuals by placing the hands and feet in ice water. In 1904, Donath and Landsteiner developed in vitro tests to demonstrate the cold hemolysin, and Mackenzie modified this by a test in which no complement is added. In 1885, Murri3 was the first to point out the relationship between cold hemoglobinuria and syphilis. Becker reviewed 37 cases of syphilitic paroxysmal cold hemoglobinuria found in the literature since 1930 and attempted to differentiate between the syphilitic and the nonsyphilitic types, stating

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