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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 misidentified as immune thrombocytopenia in an elderly patient, highlighting diagnostic challenges.

Key Points

  • This case aims to highlight the diagnostic complexities of paroxysmal nocturnal hemoglobinuria amid autoimmune conditions.
  • Case report of an 82-year-old woman with autoimmune disorders and unresponsive thrombocytopenia.
  • Evaluation included blood tests, flow cytometry, and bone marrow biopsy to confirm diagnosis.
  • Treatment involved ravulizumab following vaccinations.
  • Patient initially misdiagnosed with immune thrombocytopenia; correctly identified with paroxysmal nocturnal hemoglobinuria.
  • Significant improvement in platelet count and clinical symptoms after treatment with ravulizumab.
  • Sustained hematologic response 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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