H Wan, CK Li, TF Fok

Abstract

We describe a case of paroxysmal cold haemaglobinuria (PCH) in a 23-month-old girl who presented with passage of dark urine, fever, chills and rigors six days after an episode of upper respiratory tract infection caused by respiratory syncytial virus. Paroxysmal cold haemaglobinuria is a rare form of autoimmune anaemia occurring in children. The diagnosis is confirmed by a positive Donath-Landsteiner test. The course of the haemolysis is usually self-limiting but the degree of anaemia thus caused can be severe. Treatment is symptomatic only and may involve blood transfusion if there is evidence of cardiopulmonary compromise.