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Sunday, February 9, 2014

Paroxysmal nocturnal haemoglobinuria (PNH)


Acquired defects of the red cells membrane
Paroxysmal nocturnal haemoglobinuria (PNH)
Unknown etiology .
       Characterized by chronic intravascular haemolysis with exacerbations associated with haemoglobiniuria and marked thrombotic tendency
      Due to the presence of an abnormal haemopoietic clone , which is responsible for the production of a variable proportion of erythrocytes , granulocytes and platelets.
·        The clinical and haematological features of  PNH include  
intavascular haemolysis in the early morning .
venous thrombosis , involving unsual sites .
iron deficiency anaemia .
 . pancytopenia reduction in granulocytes and platelets as well as anaemia .  
associated with red cell lysis demonstrable in fresh acidified serum – Ham’s test or in solutions of low ionic strength – the sucrose lysis or sugarwater ‘test . the most usually screening test is the demonstration of haemosiderin in the urine.

The mainstay of treatment for PNH is blood transfusion , oral , iron oral anticoagulation is indicated for patients showing a thrombotic tendency.

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