Paroxysmal cold haemoglobinuria leading to acute renal failure: A case report

Abstract

Paroxysmal cold haemoglobinuria (PCH) is a form of autoimmune haemolytic anaemia (AIHA) characterised by sudden onset of haemoglobinuria either spontaneously or following exposure to cold. It was previously believed to be a rare form of AIHA, but is now thought to be responsible for up to 40% of cases of acute transient haemolytic anaemia in children1 following viral infections. Although the anaemia can be severe, illness is characteristically of short duration and does not recur. Published reports of PCH in children leading to renal impairment are rare, with supportive management only being used in affected cases.2, 3 We describe the case of a 2-year-old boy who developed acute renal failure (ARF) secondary to PCH, requiring peritoneal dialysis, where the early institution of plasma exchange was associated with rapid recovery of renal function.