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Cited by 448

The DOI matches its Crossref record; 131 of the 131 references it cites were found in a registry or an index.

Paroxysmal nocturnal haemoglobinuria

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Hill, Anita, DeZern, Amy E., Kinoshita, Taroh, Brodsky, Robert A.·2017·Nature Reviews Disease Primers

Abstract

Paroxysmal nocturnal haemoglobinuria (PNH) is a clonal haematopoietic stem cell (HSC) disease that presents with haemolytic anaemia, thrombosis and smooth muscle dystonias, as well as bone marrow failure in some cases. PNH is caused by somatic mutations in PIGA (which encodes phosphatidylinositol N-acetylglucosaminyltransferase subunit A) in one or more HSC clones. The gene product of PIGA is required for the biosynthesis of glycosylphosphatidylinositol (GPI) anchors; thus, PIGA mutations lead to a deficiency of GPI-anchored proteins, such as complement decay-accelerating factor (also known as CD55) and CD59 glycoprotein (CD59), which are both complement inhibitors. Clinical manifestations of PNH occur when a HSC clone carrying somatic PIGA mutations acquires a growth advantage and differentiates, generating mature blood cells that are deficient of GPI-anchored proteins. The loss of CD55 and CD59 renders PNH erythrocytes susceptible to intravascular haemolysis, which can lead to thrombosis and to much of the morbidity and mortality of PNH. The accumulation of anaphylatoxins (such as C5a) from complement activation might also have a role. The natural history of PNH is highly variable, ranging from quiescent to life-threatening. Therapeutic strategies include terminal complement blockade and bone marrow transplantation. Eculizumab, a monoclonal antibody complement inhibitor, is highly effective and the only licensed therapy for PNH.

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Metadata

Authors
Hill, A., DeZern, A. E., Kinoshita, T., & Brodsky, R. A.
Venue
Nature Reviews Disease Primers
Published
2017-05-18
Volume
3
Issue
1
Pages
17028-17028
ISSN
2056-676X (ISSN-L)
OpenAlex
W2616618502
Cited by
448
References
131
FWCI
2.79
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Paroxysmal nocturnal haemoglobinuria. https://app.cochat.ai/papers/10.1038/nrdp.2017.28
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Hill, A., DeZern, A. E., Kinoshita, T., & Brodsky, R. A. (2017). Paroxysmal nocturnal haemoglobinuria. Nature Reviews Disease Primers. https://doi.org/10.1038/nrdp.2017.28

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