Screening of patients with idiopathic venous thromboembolism for paroxysmal nocturnal hemoglobinuria clones

Alejandro Lazo-Langner; Michael J Kovacs; Ben Hedley; Fatimah Al-Ani; Michael Keeney; Martha L Louzada; Ian Chin-Yee

doi:10.1016/j.thromres.2015.04.006

Screening of patients with idiopathic venous thromboembolism for paroxysmal nocturnal hemoglobinuria clones

Thromb Res. 2015 Jun;135(6):1107-9. doi: 10.1016/j.thromres.2015.04.006. Epub 2015 Apr 11.

Authors

Alejandro Lazo-Langner¹, Michael J Kovacs², Ben Hedley³, Fatimah Al-Ani², Michael Keeney³, Martha L Louzada⁴, Ian Chin-Yee²

Affiliations

¹ Department of Medicine, Division of Hematology, University of Western Ontario, London, Ontario, Canada; Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada. Electronic address: alejandro.lazolangner@lhsc.on.ca.
² Department of Medicine, Division of Hematology, University of Western Ontario, London, Ontario, Canada.
³ Pathology and Laboratory Medicine, London Health Sciences Centre, London Ontario, Canada.
⁴ Department of Medicine, Division of Hematology, University of Western Ontario, London, Ontario, Canada; Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.

PMID: 25890452
DOI: 10.1016/j.thromres.2015.04.006

Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon disorder characterized by hemolysis, thrombosis and marrow failure. Whereas venous and arterial thrombosis is a very common symptom of the disease, the frequency of PNH clones in patients with unexplained venous thromboembolism, including deep vein thrombosis and pulmonary embolism, has not been studied. We conducted a cross sectional study evaluating the presence of PNH clones in patients with prevalent venous thromboembolism using a high sensitivity flow cytometry assay for erythrocytes and neutrophils. Among the 388 patients enrolled in the study one patient had a detectable PNH clone of 0.02% in the neutrophil population (0.26%; 95% CI 0.05 to 1.45) and no detectable erythrocyte clone. We conclude that the presence of PNH clones in patients with idiopathic venous thrombosis is rare. Screening for PNH clones among VTE patients might be better reserved for patients with signs of hemolysis.

Keywords: Paroxysmal nocturnal hemoglobinuria; Venous thromboembolism.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cohort Studies
Cross-Sectional Studies
Diagnosis, Differential
Erythrocytes / cytology
Female
Flow Cytometry
Hemoglobinuria, Paroxysmal / diagnosis*
Hemolysis
Humans
Male
Middle Aged
Neutrophils / cytology
Prevalence
Venous Thromboembolism / diagnosis*