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a Normal lab values may vary slightly among different laboratories and also between individuals. Elevated values for this chart were defined by the upper limit, and low levels by the lower limit, of normal ranges defined by either MedlinePlus, Medscape, or the Mayo Foundation. bLow haptoglobin is indicative of excess plasma hemoglobin released from hemolyzed RBCs.5,6
A critical assessment is crucial to determine the risk for morbidities and premature mortality in your patient with PNH1-3
In addition to looking at outward symptoms, use lab values to help determine your PNH patient’s
risk for serious morbidities and premature mortality. Has your PNH patient presented with any of these lab values or symptoms?
PNH case studies show how lab values and symptoms can be indicative of underlying, life-threatening complications
The following patients underwent more extensive tests when their lab signs and common symptoms indicated the possibility of serious
PNH-related morbidities. Click on their test results to find out what underlying and life-threatening complication was revealed.
Patient with elevated SCr6
- Hemoglobinuria
- No RBCs in urine under microscope
- Renal impairment
- Elevated creatinine: 4.0 mg/dL (female: 0.6-1.1 mg/dL)
- Signs of hemolysis
- Elevated LDH: 2454 IU/L (105-333 IU/L)
- Indirect hyperbilirubinemia: total/direct bilirubin, 3.01/0.71 mg/dL (total, 0.3 to 1.9 mg/dL; direct, 0 to 0.3 mg/dL)
- A renal biopsy of the patient, following diagnosis, revealed extensive kidney damage and hemosiderin accumulation caused by cell-free hemoglobin. (A) Pigment deposits.* (B) Tubular necrosis and degeneration.
*Arrows indicate pigment deposits.
Patient with dyspnea7
- Lab values from patients
with PNH showed:- Elevated LDH
- Elevated NT-proBNP
Patient with abdominal pain8
- PNH patient presented with lab
values and symptoms including:- Elevated LDH
- Elevated bilirubin
- Low hemoglobin
- Abdominal pain
Robust, up-to-date data are essential for proper diagnosis of PNH. View the latest literature on PNH.
References: 1. Hill A, et al. Br J Haematol. 2010;149(3):414-425. 2. Parker C, et al. Blood. 2005;106(12):3699-3709. 3. Weitz I, et al. Intern Med J. 2013;43(3):298-307.4. Parker CJ. Hematology Am Soc Hematol Educ Program. 2016;2016(1):208-216. 5. Rachidi S, et al. Eur J Intern Med. 2010;21(4):260-267. 6. Tsai CW, et al. Kidney Int. 2007;71(11):1187. 7. Hill A, et al. Br J Haematol. 2012;158(3):409-414. 8. Torres J, et al. Nature reviews Gastroenterology & hepatology. 2010;7(7):410-414.