SOME ACQUIRED HÆMOLYTIC ANÆMIAS OF CHILDHOOD

Summary A review has been made of the case records of eight children suffering from acquired hæmolytic anæmia, who were admitted to the Royal Alexandra Hospital for Children, Sydney, during the period 1954 to 1957. Four of the eight children were of Mediterranean racial extraction. This incidence is significantly higher than the mean incidence of children of Mediterranean racial extraction in the Australian community. Recovery from the illness was complete in each of the eight cases; in seven, the duration of the hæmolytic episode was less than four weeks. It is suggested that acquired hæmolytic anemia in childhood is usually an acute disease of short duration. In one case, excessive hæmolysis persisted for more than two years; for 16 weeks of this period, reticulocytopenia was present. The pathogenesis and prognosis of reticulocytopenia complicating autoimmune hæmolytic anæmia are discussed. In one case the hæmolytic anæmia followed closely upon ingestion of fresh broad beans. Inquiry has established the fact that the common broad bean grown in Australia is Vicia fava . The glutathione content of the erythrocytes of this child, estimated more than one year after the hæmolytic episode, was found to be significantly reduced. The significance of glutathione deficiency of the erythrocytes, in cases of acquired hæmolytic anæmia following ingestion of Vicia fava, naphthalene, sulphonamides and para‐amino salicylic acid, is briefly discussed.