Clinical manifestations of paroxysmal nocturnal hemoglobinuria (PNH).
| Due to intravascular hemolysis: |
| Anemia, hemoglobinuria, fatigue, acute/chronic renal failure, recurrent urinary tract infection, |
| Abdominal pain, bloating, back pain, headache, |
| Esophagospasms, erectile dysfunction |
| Cholelithiasis |
| Rare: |
| Choledocho dyskinesia, acute pancreatitis |
| Ischemia and ulceration of duodenum or colon |
| Due to thrombosis: |
| Venous thrombosis: |
| Abdominal vein thrombosis: Budd-Chiari, splenic, mesenteric, renal vein thrombosis |
| Portal hypertension, esophageal varices, caput medusae (dilated abdominal veins) |
| Cerebral vein thrombosis: headache, hemorrhagic infarct |
| Retinal vein thrombosis, loss of vision |
| Deep vein thrombosis, pulmonary emboli |
| Rare: |
| Cutaneous vein thrombosis, pyoderma gangrenosum |
| Arterial thrombosis (less common): |
| Stroke, myocardial infarction |
| Due to bone marrow failure: |
| Anemia, infections, bleeding |
| Myelodysplastic syndrome |
| Bone pain |
| Rare: |
| Transformation to acute myeloid leukemia (AML) |
| Due to intravascular hemolysis: |
| Anemia, hemoglobinuria, fatigue, acute/chronic renal failure, recurrent urinary tract infection, |
| Abdominal pain, bloating, back pain, headache, |
| Esophagospasms, erectile dysfunction |
| Cholelithiasis |
| Rare: |
| Choledocho dyskinesia, acute pancreatitis |
| Ischemia and ulceration of duodenum or colon |
| Due to thrombosis: |
| Venous thrombosis: |
| Abdominal vein thrombosis: Budd-Chiari, splenic, mesenteric, renal vein thrombosis |
| Portal hypertension, esophageal varices, caput medusae (dilated abdominal veins) |
| Cerebral vein thrombosis: headache, hemorrhagic infarct |
| Retinal vein thrombosis, loss of vision |
| Deep vein thrombosis, pulmonary emboli |
| Rare: |
| Cutaneous vein thrombosis, pyoderma gangrenosum |
| Arterial thrombosis (less common): |
| Stroke, myocardial infarction |
| Due to bone marrow failure: |
| Anemia, infections, bleeding |
| Myelodysplastic syndrome |
| Bone pain |
| Rare: |
| Transformation to acute myeloid leukemia (AML) |