Chronic acquired hemolytic anemia associated with hemoglobinuria and Raynaud's phenomena.

idiopathic acquired hemolytic atsemia, Group II, hemolytic atsemia followitsg irus pmseumomsia and Group III, chrotsic hemolytic atsemia with hemoglohitsuria and Raynaud’s phemsomena. A detailed accoumst. of the climsical aspects of tise three patients of Group III was published by Ferrimams, Dacie, Keele amid Fullerton2 who also made an amsalysis of msine similar cases reported in the literature. All these patietst s had certaims features its common : all exceptotse were over 50 years of age, all suffered from a chrotsic hemolytic anemia, and most of them from Raynaud’s phenomena also. The hemolytic amsemia was worse its witster time, amid episodes of acute hemolysis with hemoglobinuria occurred upots cxposure to cold. The sera of those patielsts who were adequately imsvestigated s ’ere found to contaims cold amstil)odies in high titres, capable of causitsg agglutitsatioms, hemolysis amid sensitization to amitiglobulin serum. Their Wassermann reactiomss were negative amid the cause of their disease umsktsowts. The patient now to be described may be comssidcred to bclomsg to this third group. His serum was, hoivever, unusual, for, although it comstaitscd ams extremely high-titre cold agglutinimi, its behaviour in respect to hemolysis resembled that of the Domsath-Lamsdsteiner type of hemolysin, rather thams that of the ‘a(’id hemolysins’ which have previously beets reported in this type of acquired hemolytic anemia.” 2, 3, Studies oms the ability of this amstihody to produce erythrophagocytosis were also carried out, amid its this respect, too, the behaviour differed from that of ams ‘acid hemolysits’.5