Hemolytic anemia, iron deficiency and personal history of deep vein thrombosis: consider paroxysmal nocturnal hemoglobinuria.

Abstract:

:Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disorder that must be correctly diagnose because it is a chronic disease with a real impact on the quality of life and the survival of the patients. PNH screening of all patients with anemia or thrombosis is not recommended. We report the case of a 71-year-old male patient referred for chronic anemia. Anemia work-up revealed a misunderstood association of a hemolytic anemia with a negative direct antiglobulin test and iron deficiency. The patient exhibits biological signs of intravascular hemolysis, as well as a recent history of two episodes of deep vein thrombosis. Screening for PNH by flow cytometry shown a PNH clone with a size of approximately 33% of the granulocytes and 11% of the red blood cells. An interstitial deletion of the chromosome 13 was found in the medullar karyotype. PNH through chronic intravascular hemolysis induces an urinary iron loss. This is the only cause of hemolytic anemia inducing iron deficiency.

journal_name

Ann Biol Clin (Paris)

authors

Gendron N,Arlet JB,Gaussem P,Radford-Weiss I,Dupeux S,Rosain J,La Tour RP,Darnige L

doi

10.1684/abc.2017.1277

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

580-588

issue

5

eissn

0003-3898

issn

1950-6112

pii

abc.2017.1277

journal_volume

75

pub_type

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