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December 8, 2025Blood

A diagnostic pivot: Paroxysmal nocturnal hemoglobinuria mimicking refractory immune thrombocytopenia in an elderly woman with autoimmune comorbidities

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Authors

SPShreya PatelVMVasu Malhotra

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Overview

Case report reveals paroxysmal nocturnal hemoglobinuria mimicking immune thrombocytopenia in an elderly patient, highlighting diagnostic challenges and treatment with eculizumab.

Key Points

  • To illustrate the diagnostic challenges faced in identifying paroxysmal nocturnal hemoglobinuria, especially in older adults with autoimmune conditions.
  • Descriptive case report of an elderly patient with overlapping autoimmune diseases presenting with thrombocytopenia.
  • Comprehensive laboratory assessments including bone marrow biopsy and flow cytometry analysis.
  • Evaluation for hemolysis through haptoglobin and LDH levels, alongside physician-directed therapies.
  • Patient diagnosed with paroxysmal nocturnal hemoglobinuria after initial misdiagnosis of immune thrombocytopenia.
  • Significant improvement in platelet count and normalization of LDH levels post-treatment with eculizumab.
  • Sustained hematologic response and improved quality of life reported at six-month follow-up.

Cite This Study

Patel et al. (2025) studied this question.

synapsesocial.com/papers/693624dd4fa91c937236d1a4https://doi.org/10.1182/blood-2025-6440
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