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Post a Comment Difficulties in diagnosing paroxysmal nocturnal hemoglobinuria in a municipal internal disease hospital
- Authors: Zinnatullina A.R.1, Ishmurzin G.P.1
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Affiliations:
- Kazan State Medical University
- Issue: Vol 13, No 1 (2022)
- Pages: 118-122
- Section: Case reports
- URL: https://journals.rcsi.science/clinpractice/article/view/89570
- DOI: https://doi.org/10.17816/clinpract89570
- ID: 89570
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Abstract
Background: The purpose of this work is to present a case of paroxysmal nocturnal hemoglobinuria in the clinical practice of an internist for the purpose of differential diagnosis with other diseases with the jaundice syndrome in a city hospital.
Clinical case description: Patient H., 51-year-old, was seen at the emergency department of the city hospital due to the periodic appearance of jaundice with dark-colored urine and fever. The physical and laboratory examination methods revealed an enlargement of the spleen, signs of mild hemolytic anemia, severe thrombocytopenia, a significant increase in the markers of cytolysis and cholestasis. Proteinuria and cylindruria were noted in the urine analysis. In terms of a differential diagnosis, Gilbert’s syndrome, viral hepatitis, hemorrhagic fever were considered.
Conclusion: Based on the data obtained, hemolytic and uremic syndromes were suspected. A therapy with iron preparations, vitamin B12, infusions of glucose and saline was applied with the positive clinical and laboratory dynamics. GPI-linked glycoproteins were determined on the surface of red blood cells (CD59), neutrophils (CD 24/FLAER), and monocytes by FLAER-/CD14 flow cytometry, which confirmed the diagnosis of paroxysmal nocturnal hemoglobinuria.
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##article.viewOnOriginalSite##About the authors
Aigul R. Zinnatullina
Kazan State Medical University
Author for correspondence.
Email: aigoul-zinnatullina.rust@mail.ru
ORCID iD: 0000-0003-1974-1071
SPIN-code: 9336-7331
Assistant Lecturer
Russian Federation, 49, Butlerova str., Kazan, 420012Gennady P. Ishmurzin
Kazan State Medical University
Email: ishm08@mail.ru
ORCID iD: 0000-0002-0962-5790
SPIN-code: 2870-3350
MD, PhD, Assistant Professor
Russian Federation, 49, Butlerova str., Kazan, 420012References
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