Transient Donath-Landsteiner haemolytic anaemia

Five children with 'paroxysmal cold haemoglobinuria' are described. In all of them an upper respiratory tract infection preceded the episode of acute intravascular haemolysis and potentially pathogenic organisms were recovered from four. The haematological features are presented and the importance of technique in the detection of the pathognomonic antibody is stressed and discussed in detail. Although the clinical manifestations are usually self-limiting and of short duration, it may be necessary, because of the rapidity and severity of anaemia, to provide interim support with appropriate blood transfusion. Since the disease is not usually recurrent and not clearly related to exposure to cold, it is suggested that it be re-named Donath-Landsteiner haemolytic anaemia.