ABSTRACT
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal blood disorder that presents chronic intravascular hemolysis. PNH concomitant with inherited hemolytic anemia has been rarely reported. Here, we report an interesting PNH patient who was misdiagnosed with iron deficiency anemia due to concomitant heterozygous ß-thalassemia. The patient experienced dizziness, fatigue, and restricted physical activity for the previous 3 years. Thalassemia gene analysis revealed heterozygous ß-thalassemia. Iron staining of the bone marrow demonstrated the absence of stainable iron and sideroblasts. The patient was diagnosed with iron deficiency anemia. Iron supplementation treatment was performed, but the anemia remained unresolved. The patient became transfusion dependent 1 year later and was admitted to our hospital in March 2010. Flow cytometry of the patient's peripheral blood demonstrated that 7.9% and 11.9% of the erythrocytes were CD59 and CD55 deficient, respectively. The patient was finally diagnosed with concomitant PNH and heterozygous ß-thalassemia.
Subject(s)
Anemia, Iron-Deficiency/diagnosis , Hemoglobinuria, Paroxysmal/complications , Hemoglobinuria, Paroxysmal/diagnosis , beta-Thalassemia/complications , beta-Thalassemia/diagnosis , Adult , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/physiopathology , Anemia, Iron-Deficiency/therapy , Blood Transfusion , Bone Marrow/metabolism , Bone Marrow/pathology , Diagnosis, Differential , Diagnostic Errors , Dizziness , Fatigue , Female , Ferrous Compounds/therapeutic use , Hemoglobinuria, Paroxysmal/blood , Hemoglobinuria, Paroxysmal/physiopathology , Humans , Iron/blood , Iron Deficiencies , Liver/physiopathology , Liver Function Tests , Staining and Labeling , beta-Thalassemia/blood , beta-Thalassemia/physiopathologyABSTRACT
OBJECTIVE: To observe the after-effect duration of kidney-nourishing and marrow-replenishing therapy on Mediterranean anemia. METHODS: To observe the kidney-nourishing and marrow-replenishing therapy on 58 cases of Mediterranean anemia and the influence of various relative factors on the after-effect duration. RESULTS: The after-effect duration on 58 cases varied from 3-6 months, about 4 months on average, and was not influenced by sex, clinical types, genetic types, types of Mediterranean anemia and other factors. CONCLUSION: Kidney-nourishing and marrow-replenishing therapy used to treat Mediterranean anemia can not only produce good therapeutic effect during treatment but also keep after effect lasting for about 4 months, indicating that the therapy used to treat Mediterranean anemia has good clinical after effect.