RETHINK THE DIAGNOSIS
Anemia that persists. Abdominal pain with no clear cause. A clot in an unexpected place.1-5
When the usual answers fall short, it’s time to look deeper. Paroxysmal Nocturnal Hemoglobinuria is a rare, life-threatening blood disorder driven by uncontrolled complement activation.6
PNH is rare in numbers, but significant in impact.
What do PNH symptoms look like?
When to suspect PNH?
Consider PNH if a patient has:
Any symptom listed above plus a high-risk group.1-5
High risk groups associated with PNH1–5, 22
Figure adapted from references 1–5, 23,24. This algorithm is intended to provide educational information for healthcare providers. It does not replace a healthcare provider's professional judgement or clinical diagnosis
Why early identification matters?
The Impact of Delayed Diagnosis on Patients
7x
higher risk of
thrombotic events.17,25
4.8x
higher mortality
rate.17
You’re the First Line of Insight
When symptoms don’t make sense, your clinical instinct matters.
PNH is rare but your awareness can make it visible.
Recognize early. Refer early. Change lives.
Abbreviations:
PNH – Paroxysmal Nocturnal Hemoglobinuria; AA – Aplastic Anemia; MDS – Myelodysplastic Syndromes; IVH – Intravascular Hemolysis; LDH – Lactate Dehydrogenase; GPI – Glycosylphosphatidylinositol; CD55 – Complement Decay-Ac-celerating Factor; CD59 – Membrane Attack Complex Inhibitory Protein; DVT – Deep Vein Thrombosis; FLAER – Fluorescent Aerolysin
References: 1 Röth A, et al. Eur J Haematol. 2018;101(1):3–11; 2. Borowitz MJ, et al. Cytometry B Clin Cytom. 2010;78(4):211–230; 3. Parker C, et al. Blood. 2005;106(12):3699–3709; 4. Sahin F, et al. Am J Blood Res. 2016;6(2):19–27; 5. Hillmen P, et al. Am J Hematol. 2010;85(8):553–559; 6. Lee JW, et al. Expert Rev Clin Pharmacol. 2022;7(15):851–861; 7. Jalbert JJ, et al. Blood 2019;34(S1):3407; 8. Brodsky RA. In: Hoffman R, et al., eds. Hematology: Basic Principles and Practice. Seventh edition. Elsevier; 2018:415–424; 9. Bessler M, Hiken J. Hematol Educ Program. 2008;1:103–110; 10. Brodsky RA. Haematology: Basic Principles and Practices. 4th ed. Elsevier Churchill Livingstone; 2005:419–427; 11. Kelly R, et al. Ther Clin Risk Manag. 2009;5:911–921; 12. Nishimura, et al. Medicine (Baltimore). 2004;83(3):193–207; 13. Schrezenmeier H, et al. Haematologica. 2014;99(5):922–929; 14. Schrezenmeier H, et al. Haematologica. 2014;99(5):922–929. Supplementary appendix; 15. Hill A, et al. Br J Haematol. 2010;149(3):414–425; 16. Schrezenmeier H, et al. Ann Hematol. 2020;99(7):1505–1514; 17. Jang JH, et al. J Korean Med Sci. 2016;31(2):214–221; 18. de Latour RP, et al. Blood. 2008;112(8):3099–3106; 19. Loschi M, et al. Am J Hematol. 2016;91(4); 20. Hill A, et al., Blood. 2013;121:4985–4996; 21. Malato A, et al. Blood Transfus. 2012;10:428–435; 22. Canadian PNH Network. Published 2021. https://www.pnhnetwork.- ca/patient-screening. Accessed March 2024; 23. Dezern AE, Borowitz MJ. Cytometry B Clin Cytom. 2018;94(1):16–22; 24. Illingworth A, et al. Cytometry Part B Clin Cytom. 2018;94(1):49–66; 25. Lee JW, et al. Int J Hematol. 2013;97:749–757; 26. Mitchell R, et al. SM Clin Med Oncol. 2017;1:1001; 27. Kelly RJ, et al. Blood. 2011;117:6786–6792