Unstable haemoglobin haemolytic crises: contributions of pyrexia and neutrophil oxidants

Pyrexia and the production of oxidants by phagocytic cells have been examined as two possible causes of haemolytic crises associated with infections in carriers of unstable haemoglobins. Three unstable haemoglobins were examined, both in red cells and after purification. Incubation at 40 degrees C rather than 37 degrees C resulted in only a slight increase in autoxidation rate, but a considerable increase in the rate of precipitation of the haemoglobins as Heinz bodies. Oxidants produced by activated neutrophils were capable of oxidizing haemoglobin both in solution and red cells, though there was no preferential effect on the unstable as opposed to the normal haemoglobin. It is concluded that haemolytic crises associated with infections in carriers of unstable haemoglobins can be explained by increased intracellular precipitation of the haemoglobin as Heinz bodies caused by the accompanying pyrexia.