Paroxysmal Nocturnal Hemoglobinuria (PNH) and aplastic anemia may share features at times, which can be confusing. It is important to identify which is the primary condition since the treatment is different.
A patient with aplastic anemia may have a small clone of myeloid cells with PNH features.
PNH may occur de novo or in the setting of acquired aplastic anemia.
Parameter
Classic PNH
Aplastic Anemia
bone marrow cellularity
normal or hypercellular
hypocellular
intravascular hemolysis with elevated serum LDH
present
absent
percent of granulocytes marking for PNH
> 50%
< 20%
reticulocyte count
elevated
usually decreased
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