During the past four years we have been puzzled as to the basic cause and exact classification of a hemolytic type of anemia which we have observed in 5 adults. Furthermore, we were unable to influence the clinical course either by conservative medical treatment or by more radical surgical therapy. Detailed observations have been made in each case before, during and after splenectomy, and we have had the opportunity of making postmortem examinations in 3 cases. Because of the unusual clinicopathologic syndrome, we wish to present our observations and attempt a brief review of the literature and the rather confusing ideas on the subject.
REPORT OF CASES
Case 1.—M. H., a white housewife aged 58, was admitted to the University of Nebraska Hospital March 12, 1938 and discharged May 29. For approximately three months before admission the patient had noticed a gradual loss of weight associated with weakness and followed