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AMA Arch Intern Med. 1954;93(2):304-306. doi:10.1001/archinte.1954.00240260140010.
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IT IS KNOWN that paroxysmal cold hemoglobinuria occurs most frequently in persons with congenital syphilis. The case to be presented is of particular interest because the patient was born and raised in the subtropical climate of Hawaii. The manifestations of hemoglobinuria did not occur in any degree of severity until he was exposed a cold climate, as was that in Korea.

REPORT OF CASE  A 22-year-old Hawaiian man was referred to our hospital on Jan. 12, 1952, because of a history of voiding dark-red urine. Four days prior to admission the patient felt unusually cold and chilled and voided port-wine-colored urine. He reported to the local dispensary on the same day, but physical examination and subsequent urine specimens failed to reveal any abnormality. The patient was asymptomatic until Jan. 12. On that day, while en route to the hospital, he was exposed to the cold for about two hours. Subjectively,


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