Scroll through the CATCH algorithm to reveal PNH testing recommendations
Symptoms of anemia
(eg, fatigue, tachycardia, shortness of breath, headache)
Intermittent abdominal pain
in association with 1 of the following or if the patient exhibits 1 of the following (in the absence of an above symptom)
Test for PNH with high-sensitivity flow cytometry with FLAER on peripheral blood, the gold standard diagnostic test for PNH1,6,8,e
This algorithm is intended as educational information for healthcare providers. It does not replace a healthcare provider’s professional judgment or clinical diagnosis.
aDeep vein thrombosis and/or pulmonary embolism in a patient with no antecedent major clinical risk factor for venous thromboembolism that is not provoked by surgery, trauma, immobilization, hormonal therapy (oral contraceptive or hormone replacement therapy), or active cancer.8
bUnexplained persistent cytopenia in a patient in whom (minimal) diagnostic criteria for myelodysplastic syndrome are not fulfilled.8
cAnemia, neutropenia, or thrombocytopenia.11
dUnusual sites include hepatic veins (Budd-Chiari syndrome), other intra-abdominal veins (portal, splenic, splanchnic), cerebral sinuses, and dermal veins.8
eDetects PNH cells down to a 0.01% clone size.1
In addition to looking at outward symptoms, use lab values to help determine the risk for your patient with PNH for serious morbidities and premature mortality.
fNormal laboratory values may vary slightly among different laboratories and also among individuals. Elevated values for this chart were defined by the upper limit, and low levels by the lower limit, of normal ranges identified by either MedlinePlus, Medscape, or the Mayo Foundation.
gLow haptoglobin is indicative of excess plasma hemoglobin released from hemolyzed red blood cells.27
Establish a definitive diagnosis via high-sensitivity flow cytometry with FLAER on peripheral blood, the gold standard diagnostic test for PNH1,3-5,28
eGFR=estimated glomerular filtration rate; FLAER=fluorescent aerolysin; LDH=lactate dehydrogenase; NT-proBNP=N-terminal prohormone brain natriuretic peptide; PNH=paroxysmal nocturnal hemoglobinuria; ULN=upper limit of normal.