Hemolytic Anemia With Paroxysmal Methemoglobinemia and Sulfhemoglobinemia

THE FOLLOWING case reports deal with 2 patients, independently observed, who showed a combination of intracellular methemoglobinemia, sulfhemoglobinemia and hemolytic anemia. There are a few instances in the literature of the coexistence of these two abnormal pigments in the same patient.1Although it must occur commonly after treatment with certain drugs,2no well documented reports were found of the spontaneous occurrence of both hemolytic anemia and abnormal intracellular pigments. The present studies were undertaken to elucidate the mechanism of formation of the abnormal pigments in these patients and the possible relationship to excessive destruction of blood. REPORT OF CASES Case 1. —The patient, a 37 year old housewife, was admitted to the Peter Bent Brigham Hospital March 5, 1946 for the study of cyanosis of twenty-one years' duration. Although a premature baby, the patient was entirely normal in growth and development through puberty. She had had no illnesses