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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Bibliographic Details
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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Summary: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.
ISSN:2072-8069
2543-2702