Paroxysmal nocturnal hemoglobinuria.
نویسنده
چکیده
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare bone marrow failure disorder that manifests with hemolytic anemia, thrombosis, and peripheral blood cytopenias. The absence of two glycosylphosphatidylinositol (GPI)-anchored proteins, CD55 and CD59, leads to uncontrolled complement activation that accounts for hemolysis and other PNH manifestations. GPI anchor protein deficiency is almost always due to somatic mutations in phosphatidylinositol glycan class A (PIGA), a gene involved in the first step of GPI anchor biosynthesis; however, alternative mutations that cause PNH have recently been discovered. In addition, hypomorphic germ-line PIGA mutations that do not cause PNH have been shown to be responsible for a condition known as multiple congenital anomalies-hypotonia-seizures syndrome 2. Eculizumab, a first-in-class monoclonal antibody that inhibits terminal complement, is the treatment of choice for patients with severe manifestations of PNH. Bone marrow transplantation remains the only cure for PNH but should be reserved for patients with suboptimal response to eculizumab.
منابع مشابه
Intestinal perforation in a patient with paroxysmal nocturnal hemoglobinuria
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disorder that manifests with hemolytic anemia, thrombosis, and peripheral blood cytopenias.Acute abdominal pain is one of the PNH clinical manifestations due to venous thrombosis of intra-abdominal sites including hepatic, portal, mesenteric, and splenic veins.Eculizumaband allogeneic bone marrow transplantation (BMT) arethe only w...
متن کاملگزارش یک مورد بیمار مبتلا به Paroxysmal Nocturnal Hemoglobinuria طی حاملگی
سابقه و هدف: PNH فرم نادری از آنمی همولیتیک غیر ارثی است که با همولیز حاد و مزمن داخل عروقی و هموگلوبینوری مکرر مشخص می شود و اغلب منجر به سقط و عوارض عروقی از قبیل ترمبوزهای وریدی می گردد اما برخی موارد حاملگی موفق و بدون عارضه نزد بیماران PNH مشاهده می گردد. در این راستا اقدام به معرفی یک مورد بیمار حامله مبتلا به PNH مراجعه کننده به بیمارستان رسول اکرم تهران در زمستان سال گذشته می شود. گزارش...
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متن کاملBaseline characteristics and disease burden in patients in the International Paroxysmal Nocturnal Hemoglobinuria Registry.
Paroxysmal nocturnal hemoglobinuria is a rare, acquired disease associated with hemolytic anemia, bone marrow failure, thrombosis, and, frequently, poor quality of life. The International PNH Registry is a worldwide, observational, non-interventional study collecting safety, effectiveness, and quality-of-life data from patients with a confirmed paroxysmal nocturnal hemoglobinuria diagnosis or d...
متن کاملIschemic Stroke Presenting as the First Symptom in a Setting of Paroxysmal Nocturnal Hemoglobinuria
Paroxysmal nocturnal hemoglobinuria is a hematological disorder characterized by hemolytic anemia, cytopenia, and thrombotic events. Venous thrombotic events are more commonly reported. An arterial thrombosis is a rare event in paroxysmal nocturnal hemoglobinuria. We present a case of a 32-year-old female who had symptoms of stroke and on workup, she was diagnosed as a case of paroxysmal noctur...
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ورودعنوان ژورنال:
- Blood
دوره 124 18 شماره
صفحات -
تاریخ انتشار 2014