Paroxysmal nocturnal hemoglobinuria with two new case reports

1. Two patients with paroxysmal nocturnal hemoglobinuria are reported. Thechronicity of the hemolytic process is stressed.

2. Venous blood pH was found to be generally more alkaline during sleep andwe believe that the nocturnal hemolytic process is not due to increased acidityper se.

3. A trial with (1) oral prostigmine bromide for two months, and (2) witin subcutaneous pilocarpine nitrate and pilocarpine hydrochloride showed no evidenceof reduced erythrocyte destruction and the anemia was unaffected.

4. There was no effect with hapten upon in vitro hemolysis.

5. The hemoglobin structure of the erythrocyte in this disease is normal asmeasured by the electrophoretic method.

Submitted on October 17, 1950 Accepted on April 3, 1951