{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:16:01Z","timestamp":1776978961195,"version":"3.51.4"},"reference-count":15,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T00:00:00Z","timestamp":1490140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Paroxysmal nocturnal hemoglobinuria (PNH) is a disease which diagnosis may be delayed due to variable clinical findings. We describe herein a case of PNH in a 21 year old woman who admitted with complaints of chronic weakness, intermittent spontaneous ecchymoses, and an intermittent abdominal pain. On laboratory tests thrombocytopenia and iron deficiency anemia without any clinical findings were found. Flow cytometric evaluations showed a PNH clone of 15% for erythrocytes, 64% for monocytes, and 60% for granulocytes. The patient was diagnosed with PNH and an eculizumab therapy was initiated. Following initiation of eculizumab therapy, the frequency of abdominal pain attacks decreased, hemoglobin level normalized, and platelet values increased slightly. In patients submitting with a triad of symptoms such as thrombocytopenia, iron deficiency anemia, and abdominal pain attacks of unknown etiology we suggest considering PNH. We also encourage physicians to share their similar observations in order to raise the knowledge on infrequent presentations of PNH.<\/jats:p>","DOI":"10.4081\/hr.2017.6862","type":"journal-article","created":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T11:05:54Z","timestamp":1490180754000},"page":"6862","source":"Crossref","is-referenced-by-count":1,"title":["Paroxysmal Nocturnal Hemoglobinuria in the Differential Diagnosis of Thrombocytopenia"],"prefix":"10.3390","volume":"9","author":[{"given":"Fusun","family":"Gediz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahriye","family":"Payzin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozlem","family":"Cakmak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuf","family":"Uzum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damla","family":"Ernur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahri","family":"Sahin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,3,22]]},"reference":[{"key":"ref1","first-page":"205","article-title":"Paroxysmal nocturnal hemoglobinuria: pathophysiology, natural history and treatment options in the era of biological agents","volume":"2","author":"Risitano","year":"2008","journal-title":"Biologics"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"528","DOI":"10.2174\/138955711795843301","article-title":"Achievements and limitations of complement inhibition by eculizumab in paroxysmal nocturnal hemoglobinuria: the role of complement component 3","volume":"11","author":"Risitano","year":"2011","journal-title":"Mini Rev Med Chem"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1056\/NEJM199511093331904","article-title":"Natural history of paroxysmal nocturnal hemoglobinuria","volume":"333","author":"Hillmen","year":"1995","journal-title":"N Engl J Med"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0140-6736(95)12360-1","article-title":"Paroxysmal nocturnal haemoglobinuria: long-term follow-up and prognostic factors","volume":"348","author":"Soci\u00e9","year":"1996","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s12185-013-1346-4","article-title":"Clinical signs and symptoms associated with increased risk for thrombosis in patients with paroxysmal nocturnal hemoglobinuria from a Korean Registry","volume":"97","author":"Lee","year":"2013","journal-title":"Int J Hematol"},{"key":"ref6","first-page":"1","article-title":"Multidisciplinary clinical management of paroxysmal nocturnal hemoglobinuria","volume":"5","author":"Sahin","year":"2015","journal-title":"Am J Blood Res"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.hoc.2015.01.005","article-title":"Paroxysmal nocturnal hemoglobinuria: a complement-mediated hemolytic anemia","volume":"29","author":"DeZern","year":"2015","journal-title":"Hematol Oncol Clin North Am"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"3699","DOI":"10.1182\/blood-2005-04-1717","article-title":"Diagnosis and management of paroxysmal nocturnal hemoglobinuria","volume":"106","author":"Parker","year":"2005","journal-title":"Blood"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1182\/blood-2015-06-640995","article-title":"Complement in hemolytic anemia","volume":"126","author":"Brodsky","year":"2015","journal-title":"Blood"},{"key":"ref10","first-page":"30","article-title":"PNH is a debilitating, fatal but treatable disease: same disease, different clinical presentations","volume":"5","author":"Sahin","year":"2015","journal-title":"Am J Blood Res"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/cyto.b.20525","article-title":"Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry","volume":"78","author":"Borowitz","year":"2010","journal-title":"Cytometry B Clin Cytom"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0140-6736(09)60001-5","article-title":"Eculizumab for paroxysmal nocturnal haemoglobinuria","volume":"373","author":"Parker","year":"2009","journal-title":"Lancet"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0140-6736(95)12360-1","article-title":"Paroxysmal nocturnal haemoglobinuria: long-term follow-up and prognostic factors. 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