{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:16:13Z","timestamp":1776978973308,"version":"3.51.4"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Primary myelofibrosis and paroxysmal nocturnal haemoglobinuria (PNH) are uncommon clonal blood disorders that are rarely found together. We report a case of primary myelofibrosis (PMF) with concomitant subtle PNH in a 42-year-old man who presented with a 4-week history of fatigue, unexplained chest pain, and new-onset erectile dysfunction. Bone marrow biopsy showed severe fibrosis consistent with PMF. However, smooth muscle dystonia symptoms in the form of new-onset erectile dysfunction and oesophageal spasm were not fully explained by PMF but were clues for PNH, confirmed by flow cytometric assays. Routine PNH testing for patients with new-onset PMF and clinical symptoms suggestive of PNH, as well as those with refractory anaemia despite effective therapy, is crucial since these two conditions can coexist. As a result, a lack of early testing may cause a delay in diagnosis, increasing the patient\u2019s transfusion load and the facility\u2019s costs.<\/jats:p>","DOI":"10.1093\/omcr\/omac047","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T10:08:07Z","timestamp":1653386887000},"source":"Crossref","is-referenced-by-count":3,"title":["Primary myelofibrosis with concurrent paroxysmal nocturnal haemoglobinuria presenting with erectile dysfunction"],"prefix":"10.1093","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1008-7977","authenticated-orcid":false,"given":"Zaenb","family":"Alsalman","sequence":"first","affiliation":[{"name":"Departments of Family Medicine, King Faisal University, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mortadah","family":"Alsalman","sequence":"additional","affiliation":[{"name":"Departments of Medicine, King Faisal University, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Albesher","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Prince Saud Bin Jalawi Hospital, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Alsalman","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Prince Saud Bin Jalawi Hospital, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sultan","family":"Saif","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Prince Saud Bin Jalawi Hospital, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Aldandan","sequence":"additional","affiliation":[{"name":"Departments of Pathology, Prince Saud Bin Jalawi Hospital, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Alsuliman","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Prince Saud Bin Jalawi Hospital, Eastern Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"key":"2022052410070279100_ref1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4103\/1658-5127.137081","article-title":"Paroxysmal nocturnal hemoglobinuria: Diagnosis and management protocol","volume":"5","author":"Almomen","year":"2014","journal-title":"J Appl Hematology"},{"key":"2022052410070279100_ref2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3324\/haematol.2017.183046","article-title":"Concurrent treatment of aplastic anemia\/paroxysmal nocturnal hemoglobinuria syndrome with immunosuppressive therapy and eculizumab: A UK experience","volume":"103","author":"Griffin","year":"2018","journal-title":"Haematologica"},{"key":"2022052410070279100_ref3","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1038\/s41408-018-0109-0","article-title":"Myelofibrosis Treatment Algorithm 2018","volume":"8","author":"Tefferi","year":"2018","journal-title":"Blood Cancer J"},{"key":"2022052410070279100_ref4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1002\/cyto.b.21608","article-title":"ICCS\/ESCCA consensus guidelines to detect GPI-deficient cells in paroxysmal nocturnal hemoglobinuria (PNH) and related disorders part 1 \u2013 clinical utility","volume":"94","author":"Dezern","year":"2018","journal-title":"Cytometry B Clin Cytom"},{"key":"2022052410070279100_ref5","first-page":"107","article-title":"Development of paroxysmal nocturnal hemoglobinuria in CALR-positive myeloproliferative neoplasm","volume":"7","author":"Fraiman","year":"2016","journal-title":"J Blood 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