What are the components of anemia in paroxysmal nocturnal hemoglobinuria (PNH)?

Updated: May 20, 2021
  • Author: Emmanuel C Besa, MD; Chief Editor: Sara J Grethlein, MD, FACP  more...
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Answer

The anemia of PNH may have three components: intravascular hemolysis, inadequate erythropoiesis, and superimposed iron deficiency (massive iron loss through hemoglobinuria). In view of increased rate of erythropoiesis, give 5 mg/d of folic acid orally. Assess iron stores with the use of the transferrin saturation index (TSI) and give oral ferrous sulfate if the result is <20%. (Ferritin levels should not be used for this purpose, as ferritin is an acute-phase reactant and levels can be misleading.)


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