A Potential Rapid Screening Test for Paroxysmal Nocturnal Hemoglobinuria

THE diagnosis of paroxysmal nocturnal hemoglobinuria is not obscure in the patient with classic early morning hemoglobinuria, which clears as the day progresses. However, many patients present confusing clinical features, including thrombotic complications, unexplained transfusion reactions and "refractory cytopenias" with marrow hypoplasia or iron deficiency.1 Thus, there is a need to develop simple screening tests that can be easily performed by the physician who considers paroxysmal nocturnal hemoglobinuria as a possible diagnosis. Crystalline inulin has been shown to activate the late-acting components of complement via the C3 activator system.2 Cells from patients with the disorder are unusually sensitive to hemolysis . . .