Laboratory Features of the Classic and Hypoplastic PNH Phenotypes

A patient with paroxysmal nocturnal hemoglobinuria usually falls into one of two clinical phenotypes based on laboratory features.

Phenotypes:

(1) classic

(2) hypoplastic (cytopenic)

Laboratory testing:

(1) complete blood count (CBC)

(2) bone marrow cellularity

(3) reticulocyte count

(4) serum LDH (associated with hemolysis)

(5) percent granulocytes positive for PNH markers (clone of affected cells)

Test	Classic	Hypoplastic
CBC	normal to moderate cytopenias	moderate to severe cytopenias
bone marrow cellularity	normal to hypercellular	hypocellular
reticulocyte count	increased	decreased
serum LDH	increased	normal
percent granulocytes	> 30%	< 20%

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