the very most latest and improved diagnosis

This is the final test we were waiting for. The following is from wikipedia, and it details the narrow definition of what happened to Grace. No antarctic mountain climbing for Grace. Now I'm good and freaked out.

Paroxysmal cold hemoglobinuria

From Wikipedia, the free encyclopedia

Jump to: navigation, search

Paroxysmal cold hemoglobinuria Classification & external resources
ICD-10	D59.6
ICD-9	283.2
DiseasesDB	9679
eMedicine	ped/512

Paroxysmal cold hemoglobinuria (PCH) (also known as Donath-Landsteiner syndrome) is a disease of humans that is characterized by the sudden presence of hemoglobin in the urine (called hemoglobinuria), typically after exposure to cold temperatures.

Contents [hide] 1 Presentation 2 Causes 3 Treatment and prognosis 4 Risk factors 5 See also 6 References

[edit] Presentation

In people with PCH, a polyclonal IgG autoantibody binds to red blood cell surface antigens in the cold. This can occur in a susceptible individual as blood passes through cold extremities in cold weather. When the blood returns to the warmer central circulation, the red blood cells are lysed with complement, causing intravascular hemolysis. Hemoglobinuria and anemia can then occur. The anemia may be mild or severe.

[edit] Causes

PCH can be an after effect of an infection, when a microorganism triggers the formation of antibodies that cross-react with the P antigen on the red blood cell membrane. Viral infections that can cause PCH include measles, mumps, influenza, adenovirus, chickenpox, cytomegalovirus, and Epstein-Barr virus. Bacterial infections that can cause PCH include syphilis, Haemophilus influenzae and Mycoplasma pneumoniae. PCH can also be a side effect of some vaccinations. Chronic idiopathic (of unknown cause) PCH also occurs, but it is rare.

[edit] Treatment and prognosis

Acute PCH tends to be transient and self-limited, particularly in children. Chronic PCH associated with syphilis resolves after the syphilis is treated with appropriate antibiotics. Chronic idiopathic PCH is usually mild.

[edit] Risk factors

People with PCH should avoid exposure to cold temperatures. If anemia is severe, blood transfusion may be needed. Careful compatibility testing by the blood bank is necessary because autoantibodies may interfere with blood typing. Prednisone may be used in individuals with PCH and severe anemia.

[edit] See also

• Hemolytic anemia

[edit] References

This article does not cite any references or sources. (August 2007) Please help improve this article by adding citations to reliable sources. Unverifiable material may be challenged and removed.

[hide] v • d • e Pathology: hematology (primarily D50-D77, 280-289)
RBCs/anemia/ hemoglobinopathy (Myeloid)	nutritional anemia: Iron deficiency anemia, Plummer-Vinson syndrome, Megaloblastic anemia (Pernicious anemia) hereditary hemolytic anemia: G6PD Deficiency, Thalassemia, Sickle-cell disease/trait, Hereditary spherocytosis, Hereditary elliptocytosis, Hereditary stomatocytosis acquired hemolytic anemia: Autoimmune (Warm), HUS, MAHA, PNH, PCH aplastic anemia: Acquired PRCA, Diamond-Blackfan anemia, Fanconi anemia • Sideroblastic anemia • Hemochromatosis
Coagulation/platelets (Myeloid)	coagulopathy: DIC (Congenital afibrinogenemia, Purpura fulminans) • Hemophilia (A/VII, B/IX, C/XI, XIII) • Von Willebrand disease Purpura: Henoch-Schönlein, ITP (Evans syndrome), TTP primary hypercoagulable state: Protein C deficiency - Protein S deficiency - Antithrombin III deficiency - Factor V Leiden - Activated protein C resistance - Antiphospholipid syndrome other hemorrhagic conditions: Bernard-Soulier syndrome - Glanzmann's thrombasthenia - Grey platelet syndrome - May Hegglin anomaly Essential thrombocytosis - Thrombocytopenia
Monocytes/Macrophages (Myeloid)	WHO-I histiocytosis (Langerhans cell histiocytosis) WHO-II/non-Langerhans-cell histiocytosis (Juvenile xanthogranuloma, Hemophagocytic lymphohistiocytosis) WHO-III/malignant histiocytic disorders (Acute monocytic leukemia, Malignant histiocytosis, Erdheim-Chester disease) -cytosis: Monocytosis -penia: Monocytopenia
Granulocytes (Myeloid)	-cytosis: granulocytosis (Neutrophilia, Eosinophilia, Basophilia) -penia: Granulocytopenia/agranulocytosis (Neutropenia, Kostmann syndrome)
Other/general myeloid	Chronic granulomatous disease
Lymphoid	-cytosis: Lymphocytosis -penia: Lymphopenia
Other	Asplenia/hyposplenism - Methemoglobinemia - Pancytopenia
See also hematological malignancy and immune disorders

This disease article is a stub. You can help Wikipedia by expanding it.

Retrieved from "http://en.wikipedia.org/wiki/Paroxysmal_cold_hemoglobinuria"

Categories: Hematology | Blood disorders | Disease stubs