A Clinical Note on Marchiafava-Micheli Disease

The purpose of this report is threefold. Firstly, these data reemphasize the chronicity of the disorder, paroxysmal nocturnal hemoglobinuria (PNH). Secondly, this case illustrates a clinical recovery with the persistence of the underlying erythrocyte abnormality. Thirdly, and most important, it demonstrates that routine hematological studies may fail to suggest the presence of this entity. Therefore, it seems logical to suspect that this condition is commoner than generally considered. At the time this case was first studied and published,1there had been one other reported in the American literature.2As the fundamental and meticulous work on this disorder by Ham3and Ham and Dingle4in the Thorndike Memorial Laboratory marked an early phase of many years of careful and original observations on the mechanisms of red blood cell destruction by Dr. W. B. Castle* and those who have had the privilege of associating with him,5-11it