Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is a complex hematological disorder probably first described three centuries ago, and regarded as a mystery until the 1980s, when most of its pathophysiology was elucidated, followed by the 1990s, when the underlying molecular defect was finally unraveled. The original denomination, PNH, stresses only one component of the disease (i.e., a hyperhemolytic state). A more complete contemporary definition could read as follows: an acquired blood disorder characterized by the expansion of one or a few hematopoietic cell clones that are unable to produce the glycosyl-phosphatidyl inositol (GPI) anchor, against the background of a reduced bone marrow activity. Some landmarks in the history of understanding this disorder are listed in Table 25-1. Because of its complex pathophysiology, this disorder has been variously classified among hemolytic anemias, myelodysplasia, myeloproliferative disorders, or bone marrow failure syndromes; indeed, PNH has some features of each of these. Here we will briefly summarize clinical, diagnostic, and therapeutic features, and we will then review in some detail recent progress on the genetic and pathophysiological aspects of PNH.
Keywords
Paroxysmal Nocturnal Hemoglobinuria Bone Marrow Failure Paroxysmal Nocturnal Hemoglobinuria Clone Paroxysmal Nocturnal Hemoglobinuria Patient Bone Marrow Failure SyndromePreview
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Selected References
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