Paroxysmal cold hemoglobinuria (PCH) is a type of autoimmune hemolytic anemia caused by an IgG biphasic Donath-Landsteiner antibody. The antibody binds to red blood cells at low temperatures, causing intravascular hemolysis when the body warms up. This results in hemoglobinuria and hemosiderinuria. A peripheral blood film may show auto-agglutination of red blood cells, spherocytes, and reticulocytes. PCH is associated with viral illnesses in children or acquired syphilis.

1. Paroxysmal cold hemoglobinuria - PCH
Autoimmune haemolytic anaemia
Developed by-Dr.Abdulrazzaq Othman Alagbare
M.D M.S.c C.P - Lecturer of Hematology and Immunohematology
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2. Paroxysmal cold hemoglobinuria - PCH
Definition: It is cold agglutinin disease With An IgG biphasic Donath-
Landsteiner antibody (Donath-Landsteiner antibody.)
ANEMIA -Dr.Alagbare
What means the
IgG is biphasic?
In low
tempreture
binding with
RBC
causes intravascular
hemolysis after
warming.
In 37 C

3. Paroxysmal cold hemoglobinuria - PCH
MECHANISM
The antibodies cause intravascular hemolysis with hemoglobinuria and
hemosiderinuria
Hemolysis results from exposure to cold, which may even be localized (eg,
from drinking cold water, from washing hands in cold water
IgG binds to RBCs at low temperatures and causes intravascular
hemolysis after warming.
ANEMIA -Dr.Alagbare

4. Paroxysmal cold hemoglobinuria - PCH
Risk factor: viral illness in young children
or acquired syphilis
CBC: anemia, increase plasma Hb,
Urine : hemoglobinuria and hemosiderinuria
ANEMIA -Dr.Alagbare

5. Paroxysmal cold hemoglobinuria - PCH
PBS: Erythrophagocytosis by neutrophils is common and is distinctive
Peripheral blood film showing auto-agglutination, spherocytes and
reticulocytes
ANEMIA -Dr.Alagbare
Erythrophagocytosiauto-agglutination, spherocytes

6. Paroxysmal cold haemoglobinuria:
Donath Landsteiner antibody positive haemolytic anaemia.
Peripheral blood film showing auto-agglutination,
spherocytes and reticulocytes

7. ‫رب‬ ‫هلل‬ ‫الحمد‬
‫العالمين‬
‫ابتغي‬ ‫العمل‬ ‫هذا‬
‫الكريم‬ ‫هللا‬ ‫وجه‬ ‫به‬
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