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November 10, 1945


JAMA. 1945;129(11):766. doi:10.1001/jama.1945.02860450052019

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To the Editor:—  A boy aged 2 years of Italian parentage was admitted to the hospital because of dysphagia of about eighteen hours' duration, increasing pallor and mild jaundice of about twenty-four hours' duration, vomiting, malaise and generalized weakness. The child was well nourished. The skin and sclerae had a mild icterus. There was a distinct pallor to the skin. The spleen was not palpable. The temperature was 99.8 F. Otherwise the physical examination was negative. Laboratory studies revealed 25 per cent hemoglobin, 1,390,000 red blood cells and 45,650 white blood cells with 70 per cent polymorphonuclear leukocytes and 30 per cent lymphocytes. The urine showed 10 mg. of albumin. A tentative diagnosis of acute hemolytic anemia was made, the etiology to be determined. Erythrocyte fragility tests were normal. X-ray studies of the skull revealed no changes to be compatible with Cooley's anemia. Transfusions were given and the blood picture

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