@Article{, title={A female with classical paroxysmal nocturnal hemoglobinuria misdiagnosed as megaloblastic anemia}, author={Dr. Sana D. Jalal,}, journal={Iraq Joural of Hematology المجلة العراقية لامراض الدم}, volume={8}, number={2}, pages={81-83}, year={2019}, abstract={Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of the hematopoietic stemcells, which manifests as bone marrow failure, hemolytic anemia, and thrombosis. PNH affects bothsexes equally and may present at any age, although it is most often diagnosed in young adulthood.Here, we report a case of a middle‑aged woman, presented with one and a half year history of anemia,significant fatigue, backache, and persistent high erythrocyte sedimentation rate. The patient hasno organomegaly and did not give a history of thrombotic events previously. She was consideredas a case of megaloblastic anemia at another center and treated accordingly. Her full blood countshowed mild macrocytic anemia with slight polychromasia. The hemolytic anemia workup revealedslightly raised serum bilirubin (unconjugated) and undetectable haptoglobin with hemosiderin in urine.Ham’s test was positive, and the diagnosis of PNH was confirmed by flow cytometry. The patientwas treated with short‑course steroids and folic acid, and her general condition has become stable

} }