Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon acquired complement-mediated hemolytic anemia characterized by continuous destruction of red blood cells leading to dark red or black colored urine. A 42-year-old man has been experiencing recurring jaundice, gastrointestinal discomfort, and h...

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Main Authors: Majed Abdul Basit Momin, Seema Afroze, G. Vamshi Krishna Reddy, Rahul Dev Singh Rathore
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Iraqi Journal of Hematology
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Online Access:https://journals.lww.com/10.4103/ijh.ijh_103_24
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author Majed Abdul Basit Momin
Seema Afroze
G. Vamshi Krishna Reddy
Rahul Dev Singh Rathore
author_facet Majed Abdul Basit Momin
Seema Afroze
G. Vamshi Krishna Reddy
Rahul Dev Singh Rathore
author_sort Majed Abdul Basit Momin
collection DOAJ
description Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon acquired complement-mediated hemolytic anemia characterized by continuous destruction of red blood cells leading to dark red or black colored urine. A 42-year-old man has been experiencing recurring jaundice, gastrointestinal discomfort, and high-colored urine for the past 2 years. His hemogram and antiglobulin tests were normal. The hemolytic anemia workup revealed reticulocytosis, hemoglobinuria, urine hemosiderin, elevated indirect bilirubinemia, and extremely low haptoglobin. A high index of suspicion for PNH prompted the laboratory physician to do flow cytometry, which confirmed the diagnosis of classical PNH. Here, we discuss a case of PNH that remained undiagnosed for years, detailing how we successfully identified a rare and confusing case of hemolytic anemia without cytopenia.
format Article
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institution Kabale University
issn 2072-8069
2543-2702
language English
publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Iraqi Journal of Hematology
spelling doaj-art-4fff8eb33aea47cd9de794744ddd0b7c2025-08-20T03:31:34ZengWolters Kluwer Medknow PublicationsIraqi Journal of Hematology2072-80692543-27022025-01-0114112713010.4103/ijh.ijh_103_24Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopeniaMajed Abdul Basit MominSeema AfrozeG. Vamshi Krishna ReddyRahul Dev Singh RathoreParoxysmal nocturnal hemoglobinuria (PNH) is an uncommon acquired complement-mediated hemolytic anemia characterized by continuous destruction of red blood cells leading to dark red or black colored urine. A 42-year-old man has been experiencing recurring jaundice, gastrointestinal discomfort, and high-colored urine for the past 2 years. His hemogram and antiglobulin tests were normal. The hemolytic anemia workup revealed reticulocytosis, hemoglobinuria, urine hemosiderin, elevated indirect bilirubinemia, and extremely low haptoglobin. A high index of suspicion for PNH prompted the laboratory physician to do flow cytometry, which confirmed the diagnosis of classical PNH. Here, we discuss a case of PNH that remained undiagnosed for years, detailing how we successfully identified a rare and confusing case of hemolytic anemia without cytopenia.https://journals.lww.com/10.4103/ijh.ijh_103_24flowcytometryintravascular hemolysisparoxysmal nocturnal hemoglobinuria
spellingShingle Majed Abdul Basit Momin
Seema Afroze
G. Vamshi Krishna Reddy
Rahul Dev Singh Rathore
Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia
Iraqi Journal of Hematology
flowcytometry
intravascular hemolysis
paroxysmal nocturnal hemoglobinuria
title Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia
title_full Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia
title_fullStr Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia
title_full_unstemmed Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia
title_short Classic paroxysmal nocturnal hemoglobinuria: A puzzling case of hemolytic anemia without cytopenia
title_sort classic paroxysmal nocturnal hemoglobinuria a puzzling case of hemolytic anemia without cytopenia
topic flowcytometry
intravascular hemolysis
paroxysmal nocturnal hemoglobinuria
url https://journals.lww.com/10.4103/ijh.ijh_103_24
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AT gvamshikrishnareddy classicparoxysmalnocturnalhemoglobinuriaapuzzlingcaseofhemolyticanemiawithoutcytopenia
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