Hematology

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Paroxysmal Nocturnal Hemoglobinuria (PNH) also known as Marchiafava-Micheli Syndrome (named after Dr. Ettore Marchiafava and Dr. Ferdinando Micheli)

For every million people only a few of them will get paroxysmal nocturnal hemoglobinuria which makes this a rare blood disease. Paroxysmal nocturnal hemoglobinuria affects both sexes and all ages equally. Patients with PNH suffer from a faulty or missing PGI-A gene which can be found within the erythrocytes, leukocytes, and thrombocytes. Paroxysmal nocturnal hemoglobinuria is not an inherited disease but is considered an acquired disease because the hematopoietic stem cells over time begin to change and malfunction. This process of cell change is called somatic mutation. Although not all of the blood cells will have this faulty gene the ones that do will only be able to produce more mutated cells creating a cycle of increasing damaged cells that keeps expanding. The number of mutated cells a person with this disease has is what determines the degree to which they will suffer from the symptoms. As the number of PNH cells increases so does the symptoms. The PIG-A gene also plays a part in sending the signals to the body on how to make GPI anchors that secure compliment regulating proteins to blood cell membranes. When these protecting proteins lack the ability to attach they leave the blood cells vulnerable to attack from the body’s own immune system. Without compliment regulating proteins the immune system reacts as if the cells were an infection or bacteria and destroys them. When the body does not have sufficient red blood cells the condition is called hemolytic anemia. PNH also damages platelets (thrombocytes) interfering with the ability to form blood clots, because of th...

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...destroys PNH by transplanting healthy marrow (most often from a relative) into the patient. There is a VERY high mortality rate with this cure so generally it is reserved for patients who suffer from PNH along with another disease such as leukemia, aplastic anemia, or myelodysplastic syndrome and all other treatment options are no longer enough.

Works Cited

http://www.ncbi.nlm.nih.gov/books/NBK22166/

http://ghr.nlm.nih.gov/condition/paroxysmal-nocturnal-hemoglobinuria

http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm

http://www.nlm.nih.gov/medlineplus/ency/article/000534.htm

http://en.wikipedia.org/wiki/Paroxysmal_nocturnal_hemoglobinuria#Treatment

http://rarediseases.info.nih.gov/GARD/Disease.aspx?PageID=4&DiseaseID=7337

http://bloodjournal.hematologylibrary.org/content/113/26/6522.full

http://www.haematologica.org/cgi/content/full/95/6/855

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