Exertional haemoglobinuria: a report on three cases with studies on the haemolytic mechanism

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Abstract
Three cases of exertional haemoglobinuria are described. So far, the cause of the underlying haemolysis in this condition has not been satisfactorily explained, but in the cases described, the haemoglobinuric episodes appeared to be related to traumatic damage to the soles of the feet. Experimental studies support the hypothesis that the intravascular haemolysis results from mechanical damage to red cells in the soles of the feet. Furthermore, since adopting remedial measures, haemoglobinuria has not recurred in any of the patients, although they have continued to pursue their strenuous athletic activities.