samerhasna
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what is the modern procedures for PNH(paroxysmal nocturnal hemoglubenourea) diagnosis?
Edited by samerhasna on 06/25/05 - 02:15 AM
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optimestic
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| drvic
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you mean, besides Ham test and Sucrose cell lysis test?
besides the presence of hemoglobinuria suggestive of hemolysis and the reduction of RBC acetylcholinesterase levels, the more specific tests for diagnosis are - flow cytometry using anti CD55 and CD59 antibodies.
for this you should understand the pathogenesis of PNH - its caused by deficiency of glycolipid anchors of some proteins that are normally present on RBC surfaces and which therefore protect them from undergoing hemolysis from complement. these proteins are
CD55 - Decay accelerating Factor
CD59- MIRL - membrane inhibitor of reactive lysis
C8 binding protein.
so flowcytometry detects these reduced membrane bound proteins and helps make the diagnosis - more specific that the classic oldies i mentioned above...
also remember that hemolysis is truly paroxysmal and nocturnal in only 25% of patients - rest have continuous hemolysis!
hope that helps
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| samerhasna
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thank you drvic for that correct full answer
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optimestic
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| chemamr
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good question samerhasna ! 
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