Megaloblastic Crisis in Paroxysmal Nocturnal Hemoglobinuria

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Abstract
PAROXYSMAL nocturnal hemoglobinuria is a rarely recognized cause of hemolytic anemia. Although the exact etiology remains obscure, the erythrocytes develop a defect that sensitizes them to increased destruction in an acid medium.1 , 2 It is becoming more evident that the disease must be considered in the differential diagnoses of many illnesses because of its variable clinical manifestations.3 In the case reported below, an "aplastic-megaloblastic" crisis was accompanied by hemolysis. The development of a megaloblastic maturation arrest in the course of chronic hemolytic anemias, both congenital and acquired, is being recognized more frequently,4 5 6 7 and has recently been summarized by Lindenbaum and Klipstein. . . .