International Journal of Hematology

, Volume 77, Issue 2, pp 113–120 | Cite as

Clinical Manifestations of Paroxysmal Nocturnal Hemoglobinuria: Present State and Future Problems

  • Wendell F. RosseEmail author
  • Junichi Nishimura
Progress in hematology


The clinical pathology of paroxysmal nocturnal hemoglobinuria (PNH) involves 3 complications: hemolytic anemia, thrombosis, and hematopoietic deficiency. The first 2 are clearly the result of the cellular defect in PNH, the lack of proteins anchored to the membrane by the glycosylphosphatidylinositol anchor. The hemolytic anemia results in syndromes primarily related to the fact that the hemolysis is extracellular. Thrombosis is most significant in veins within the abdomen, although a number of other thrombotic syndromes have been described. The hematopoietic deficiency may be the same as that in aplastic anemia, a closely related disorder, and may not be due to the primary biochemical defect. The relationship to aplastic anemia suggests a nomenclature that emphasizes the predominant clinical manifestations in a patient. This relationship does not explain cases that appear to be related to myelodysplastic syndromes or the transition of some cases of PNH to leukemia. Treatment, except for bone marrow transplantation, remains noncurative and in need of improvement.

Key words

Paroxysmal nocturnal hemoglobinuria Hemolysis Thrombosis Aplastic anemia Myelodysplasia 


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Copyright information

© The Japanese Society of Hematology 2003

Authors and Affiliations

  1. 1.Divisions of HematologyDuke University Medical CenterDurham
  2. 2.Medical Oncology-Bone Marrow Transplantation, Department of MedicineDuke University Medical CenterDurham

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