A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy

Due to a mutation in the phosphatidylinositol glycan class A (PIGA) gene, hemolytic anemia, thrombosis, and bone marrow failure are the hallmarks of the uncommon hematologic illness known as paroxysmal nocturnal hemoglobinuria (PNH). Although by different processes, hemoglobinopathies, such as thala...

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Main Authors: Aria Namiq Chaqmachi, Brwa Ali Hussein
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Iraqi Journal of Hematology
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Online Access:https://journals.lww.com/10.4103/ijh.ijh_83_24
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author Aria Namiq Chaqmachi
Brwa Ali Hussein
author_facet Aria Namiq Chaqmachi
Brwa Ali Hussein
author_sort Aria Namiq Chaqmachi
collection DOAJ
description Due to a mutation in the phosphatidylinositol glycan class A (PIGA) gene, hemolytic anemia, thrombosis, and bone marrow failure are the hallmarks of the uncommon hematologic illness known as paroxysmal nocturnal hemoglobinuria (PNH). Although by different processes, hemoglobinopathies, such as thalassemia, can manifest with hemolytic anemia. The 40-year-old female patient in this case study had a complicated clinical presentation with both hemoglobinopathy – more precisely, a form of thalassemia – and PNH. Abdominal pain, fatigability, and dark urine episodes were the patient’s initial complaints. PNH was confirmed by laboratory testing, which showed low hemoglobin, increased lactate dehydrogenase, and hemosiderinuria. Thalassemia was discovered by a further hematologic workup. It is quite uncommon for hemoglobinopathy and PNH to coexist. This case emphasizes how crucial it is to perform a thorough hematologic examination on patients who have hemolytic anemia to customize treatment plans and enhance patient outcomes. We will discuss therapeutic hurdles, possible treatment choices, and the clinical journey of the patient with a classical type of PNH with access only to steroids, blood transfusions, and supplements.
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spelling doaj-art-f2fedc30147d42a89c49c1bc267a180c2025-01-09T13:55:22ZengWolters Kluwer Medknow PublicationsIraqi Journal of Hematology2072-80692543-27022024-12-0113232432710.4103/ijh.ijh_83_24A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathyAria Namiq ChaqmachiBrwa Ali HusseinDue to a mutation in the phosphatidylinositol glycan class A (PIGA) gene, hemolytic anemia, thrombosis, and bone marrow failure are the hallmarks of the uncommon hematologic illness known as paroxysmal nocturnal hemoglobinuria (PNH). Although by different processes, hemoglobinopathies, such as thalassemia, can manifest with hemolytic anemia. The 40-year-old female patient in this case study had a complicated clinical presentation with both hemoglobinopathy – more precisely, a form of thalassemia – and PNH. Abdominal pain, fatigability, and dark urine episodes were the patient’s initial complaints. PNH was confirmed by laboratory testing, which showed low hemoglobin, increased lactate dehydrogenase, and hemosiderinuria. Thalassemia was discovered by a further hematologic workup. It is quite uncommon for hemoglobinopathy and PNH to coexist. This case emphasizes how crucial it is to perform a thorough hematologic examination on patients who have hemolytic anemia to customize treatment plans and enhance patient outcomes. We will discuss therapeutic hurdles, possible treatment choices, and the clinical journey of the patient with a classical type of PNH with access only to steroids, blood transfusions, and supplements.https://journals.lww.com/10.4103/ijh.ijh_83_24complement inhibitorsparoxysmal nocturnal hemoglobinuriasteroidthalassemia
spellingShingle Aria Namiq Chaqmachi
Brwa Ali Hussein
A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
Iraqi Journal of Hematology
complement inhibitors
paroxysmal nocturnal hemoglobinuria
steroid
thalassemia
title A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
title_full A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
title_fullStr A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
title_full_unstemmed A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
title_short A 2-decade survival from a double hemolytic disease: A case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
title_sort 2 decade survival from a double hemolytic disease a case of paroxysmal nocturnal hemoglobinuria with hemoglobinopathy
topic complement inhibitors
paroxysmal nocturnal hemoglobinuria
steroid
thalassemia
url https://journals.lww.com/10.4103/ijh.ijh_83_24
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