PAROXYSMAL NOCTURNAL HEMOGLOBINURIA: REPORT OF FOUR CASES, WITH OBSERVATIONS ON TREATMENT WITH 3,3′-METHYLENEBIS (4-HYDROXYCOUMARIN) (DICUMAROL)

Publisher Website
Google Scholar
Abstract
Four new cases are reported; in each the correct diagnosis was not made for a number of years. The most frequent error made was to consider them cases of chronic renal disease. Acquired hemolytic anemia and aplastic anemia were also incorrectly assumed to be present. The approach to the differential diagnosis is outlined. Effectiveness of bishydroxy-coumarin in the treatment of this disease was investigated. One patient died with multiple thrombosis, which might have been prevented with adequate administration of anticoagulants. In the other 3 cases bishydroxycoumarin appeared to control to some degree the rate of the hemolytic process. It did not prevent crises completely; but adequately controlled prothrom-bin times did appear to be associated with decreased rates of hemolysis too frequently to consider coincidence a likely explanation.