Paroxysmal Nocturnal Hemoglobinuria With Two New Case Reports

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

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

3. A trial with (1) oral prostigmine bromide for two months, and (2) witin subcutaneous pilocarpine nitrate and pilocarpine hydrochloride showed no evidence of 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 as measured by the electrophoretic method.