BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuParoxysmal cold hemoglobinuria (PCH)PCHParoxysmal cold hemoglobinuria (PCH) is a rare blood disorder in which the body's immune system produces antibodies that destroy red blood cells. It occurs when the person is exposed to cold temperatures.AntibodiesAn antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...ImageRead Article Now Book Mark Article Causes PCH only occurs in the cold, and affects mainly the hands and feet. Antibodies attach (bind) to red blood cells. This allows other proteins in the blood (called complement) to also latch on. The antibodies destroy the red blood cells as they move through the body. As the cells are destroyed, hemoglobin, the part of red blood cells that carries oxygen, is released into the blood and passed in the urine.PCH has been linked to secondary syphilis, tertiary syphilis, and other viral or bacterial infections. Sometimes the cause is unknown.The disorder is rare. Symptoms Symptoms may include:Chills Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article Back pain Leg pain Leg painLeg pain is a common problem. It can be due to a cramp, injury, or other cause.ImageRead Article Now Book Mark Article Abdominal pain Abdominal painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.ImageRead Article Now Book Mark Article Headache HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article General discomfort, uneasiness, or ill feeling (malaise) MalaiseMalaise is a general feeling of discomfort, illness, or lack of well-being.Read Article Now Book Mark Article Blood in the urine (red urine) Blood in the urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Exams and Tests Laboratory tests can help diagnose this condition.Bilirubin levels are high in blood and urine. Complete blood count (CBC) shows anemia. Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Coombs test is negative. Coombs testThe Coombs test looks for antibodies that may stick to your red blood cells and cause red blood cells to die too early.Read Article Now Book Mark Article Donath-Landsteiner test is positive. Donath-Landsteiner testThe Donath-Landsteiner test is a blood test to detect harmful antibodies related to a rare disorder called paroxysmal cold hemoglobinuria. These ant...Read Article Now Book Mark Article Lactate dehydrogenase level is high. Treatment Treating the underlying condition can help. For example, if PCH is caused by syphilis, symptoms may get better when the syphilis is treated.In some cases, medicines that suppress the immune system are used. Outlook (Prognosis) People with this disease often get better quickly and do not have symptoms between episodes. In most cases, the attacks end as soon as the damaged cells stop moving through the body. Possible Complications Complications may include:Continued attacks Kidney failure Severe anemiaAnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your health care provider if you have symptoms of this disorder. Your provider can check for other causes of the symptoms and decide whether you need treatment. Prevention People who have been diagnosed with this disease can prevent future attacks by staying out of the cold.Open ReferencesReferencesMichel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 146.Michel M, Jäger U. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 47.AllVideoImagesTogBlood cells - illustration Blood is comprised of red blood cells, platelets, and various white blood cells.Blood cellsillustrationBlood cells - illustration Blood is comprised of red blood cells, platelets, and various white blood cells.Blood cellsillustration Tests for Paroxysmal cold hemoglobinuria (PCH) Donath-Landsteiner testHemoglobinuria testSerum free hemoglobin testRelated Information Antibody(Special Topic)Hemoglobin(Medical Test) Review Date: 3/31/2024 Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. 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Paroxysmal cold hemoglobinuria (PCH)PCHParoxysmal cold hemoglobinuria (PCH) is a rare blood disorder in which the body's immune system produces antibodies that destroy red blood cells. It occurs when the person is exposed to cold temperatures.AntibodiesAn antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...ImageRead Article Now Book Mark Article Causes PCH only occurs in the cold, and affects mainly the hands and feet. Antibodies attach (bind) to red blood cells. This allows other proteins in the blood (called complement) to also latch on. The antibodies destroy the red blood cells as they move through the body. As the cells are destroyed, hemoglobin, the part of red blood cells that carries oxygen, is released into the blood and passed in the urine.PCH has been linked to secondary syphilis, tertiary syphilis, and other viral or bacterial infections. Sometimes the cause is unknown.The disorder is rare. Symptoms Symptoms may include:Chills Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article Back pain Leg pain Leg painLeg pain is a common problem. It can be due to a cramp, injury, or other cause.ImageRead Article Now Book Mark Article Abdominal pain Abdominal painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.ImageRead Article Now Book Mark Article Headache HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article General discomfort, uneasiness, or ill feeling (malaise) MalaiseMalaise is a general feeling of discomfort, illness, or lack of well-being.Read Article Now Book Mark Article Blood in the urine (red urine) Blood in the urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Exams and Tests Laboratory tests can help diagnose this condition.Bilirubin levels are high in blood and urine. Complete blood count (CBC) shows anemia. Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Coombs test is negative. Coombs testThe Coombs test looks for antibodies that may stick to your red blood cells and cause red blood cells to die too early.Read Article Now Book Mark Article Donath-Landsteiner test is positive. Donath-Landsteiner testThe Donath-Landsteiner test is a blood test to detect harmful antibodies related to a rare disorder called paroxysmal cold hemoglobinuria. These ant...Read Article Now Book Mark Article Lactate dehydrogenase level is high. Treatment Treating the underlying condition can help. For example, if PCH is caused by syphilis, symptoms may get better when the syphilis is treated.In some cases, medicines that suppress the immune system are used. Outlook (Prognosis) People with this disease often get better quickly and do not have symptoms between episodes. In most cases, the attacks end as soon as the damaged cells stop moving through the body. Possible Complications Complications may include:Continued attacks Kidney failure Severe anemiaAnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your health care provider if you have symptoms of this disorder. Your provider can check for other causes of the symptoms and decide whether you need treatment. Prevention People who have been diagnosed with this disease can prevent future attacks by staying out of the cold.Open ReferencesReferencesMichel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 146.Michel M, Jäger U. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 47.