Serum Anti-YG Globulin Factors in Paroxysmal Nocturnal Hemoglobinuria

I N PAROXYSMAL NOCTURNAL HEMOGLOBINURIA (PNH) accelerated destruction of abnormal red cells occurs within an apparently benign extracorpuscular environment.1 Although the underlying cellular defect has not yet been fully elucidated, it has long been recognized that, in vitro, PNII erythrocytes are extraordinarily susceptible to immune lysis. The possibility exists that, in vivo, destruction of the PNH red cell may be provoked by immunologic mechanisms. However, evidence for such a process is usually lacking,2 and to the present time there has been no consistently recognized abnormahity in the serum globulins or in serum complement activity. It was, therefore, of considerable interest that serum from a patiemit with PNH was found to agglutinate compatible red cells that had been sensitized with some incomplete Rh antisera. This finding suggested that the patient’s serum contained rheumatoid factor ( RF). However, neither the patient’s history nor physical findings suggested the diagnosis of rheumatoid arthritis. Since a search of the literature revealed no previously noted association between PNH and anti-yG globulin factors, additional sera from PNH patients were sought; a total of 25 such patients were finally collected for study.#{176} The results of this investigation, previously reported in preliminary form,4 indicate that anti-yG globulin factors are commonly present in the sera of patients with PNH.