Paroxysmal cold hemoglobinuria

Paroxysmal cold hemoglobinuria is a rare variant of hemolytic anemia which occurs due to the prescense of a cold antibody. Here this is a IgG antibody directed against the P antigen on the erythrocyte membrane. Complement fixation is initiated by cold, but does not proceed to lysis until the blood temperature rises to 37 degree celsius. Patients suffer chills, fever, muscle pain and hemoglobinuria following exposure to cold. An acute variant of the disease follows certain viral infections. A more chronic form of the disease occurs in syphilis.The Donath-Landsteiner test aids in the diagnosis of paroxysmal cold hemoglobinuria. The test is performed by cooling the blood sample to 4 degree celsius initially and then warming it up to 37 degree celsius. It is called positive if hemolysis develops in the sample.



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