Haemolytic anaemia--PNH type II cells presenting a diagnostic dilemma

Nikhil Pande

Research output: Contribution to journalArticle

Abstract

A 28-year-old man presented with a history of intermittent haematuria over the past 10 years usually following fever episodes and requiring blood transfusions during the episodes. History of any thrombotic complications, chest pain or erectile dysfunction was not forthcoming. Examination revealed severe pallor with mild icterus and mild splenomegaly. His blood picture showed pancytopenia with elevated reticulocytes and indirect hyperbilirubinaemia. Indirect Coombs test was positive but direct was negative, serum lactate dehydrogenase was elevated and agglutinins were found to be of IgG type. Bone marrow showed a hypercellular marrow with myeloid and megakaryocytes suppressed. Donath-Landsteiner antibodies were found to be negative ruling out paroxysmal cold haemoglobinuria. Flow cytometry was performed with a suspicion of paroxysmal nocturnal haemoglobinuria (PNH) and was shown to be partially negative for CD59 but positive for CD55, a pattern consistent with type II PNH.

Original languageEnglish
JournalBMJ Case Reports
Volume2014
DOIs
Publication statusPublished - 01-01-2014
Externally publishedYes

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Paroxysmal Hemoglobinuria
Hemolytic Anemia
Bone Marrow
Pallor
Coombs Test
Pancytopenia
Hyperbilirubinemia
Megakaryocytes
Agglutinins
Reticulocytes
Splenomegaly
Hematuria
Erectile Dysfunction
Jaundice
Chest Pain
L-Lactate Dehydrogenase
Blood Transfusion
Flow Cytometry
Fever
Immunoglobulin G

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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abstract = "A 28-year-old man presented with a history of intermittent haematuria over the past 10 years usually following fever episodes and requiring blood transfusions during the episodes. History of any thrombotic complications, chest pain or erectile dysfunction was not forthcoming. Examination revealed severe pallor with mild icterus and mild splenomegaly. His blood picture showed pancytopenia with elevated reticulocytes and indirect hyperbilirubinaemia. Indirect Coombs test was positive but direct was negative, serum lactate dehydrogenase was elevated and agglutinins were found to be of IgG type. Bone marrow showed a hypercellular marrow with myeloid and megakaryocytes suppressed. Donath-Landsteiner antibodies were found to be negative ruling out paroxysmal cold haemoglobinuria. Flow cytometry was performed with a suspicion of paroxysmal nocturnal haemoglobinuria (PNH) and was shown to be partially negative for CD59 but positive for CD55, a pattern consistent with type II PNH.",
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Haemolytic anaemia--PNH type II cells presenting a diagnostic dilemma. / Pande, Nikhil.

In: BMJ Case Reports, Vol. 2014, 01.01.2014.

Research output: Contribution to journalArticle

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