PMC4209786_01
Hemosiderinuria. Perls' reaction weakly positive in the urine.
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Analysis of the urine sample revealed the presence of coluria and weakly positive haemosiderin (Perls' reaction, Figure 1) indicating intravascular haemolysis, with absent bilirubin, and no red cells were seen under microscope. Afterwards we placed the tube at 37 C for 30 minutes, centrifuged it at 37 C, and examined it for lysis (Figure 3, tube 1).
Direct Donath-Landsteiner positive test.
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The test was positive for the presence of hemolysis in the sample that had been chilled (Figure 2, tube 2).
Indirect Donath-Landsteiner test. Tube 1: OP + red cells suspension + patient's serum. Double incubation at 0 C and 37 C. Tube 2: duplicate of tube 1 but conserved strictly at 37 C. Tube 3: duplicate of tube 1 + compatible fresh normal EDTA-plasma and double incubation. Tube 4: duplicate of tube 1 + compatible fresh normal serum and double incubation. Tube 5: OP + red cells suspension + ABO compatible fresh serum and double incubation.
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Afterwards we placed the tube at 37 C for 30 minutes, centrifuged it at 37 C, and examined it for lysis (Figure 3, tube 1).