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Lack of specific morphological changes of paroxysmal nocturnal hemo globinuria erythrocytes

, : Lack of specific morphological changes of paroxysmal nocturnal hemo globinuria erythrocytes. Scanning Electron Microscopy (2): 563-568

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemolytic disorder characterized by erythrocytes with an increased sensitivity to complement lysis. Granulocytopenia and thrombocytopenia may also occur. The fundamental nature of the red blood cell membrane defect in PNH has not been clarified. The morphology of erythrocytes was studied from 3 patients with PNH with the scanning electron microscope (SEM) to determine whether any membrane changes specific for PNH could be found. Various other disorders and normals were used for comparison. SEM of PNH erythrocytes revealed various morphological changes of the red blood cell (RBC). Protuberances and pits on the red blood cell membrane were seen. During severe and continuous hemolysis many of the erythrocytes had the aforementioned abnormalities. Few RBC had morphological changes when hemolysis was mild. Similar morphological changes of RBC in other disorders were seen. The morphological changes in PNH studied by SEM are apparently nonspecific and secondary to the hemolytic process itself. Associated Fe deficiency may also be a contributing factor.


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