Korean J Clin Pathol.
1998 Mar;18(1):1-6.
CD55 and CD59 : New Diagnostic Tests for Paroxysmal Nocturnal Hemoglobinuria
- Affiliations
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- 1Department of Clinical Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Abstract
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BACKGROUND: To diagnose paroxysmal nocturnal hemoglobinuria (PNH), the conventional methods such as sucrose lysis test and Ham's test have been used. But their sensitivities were so low that it has been difficult to confirm the diagnosis of PNH. And it has been reported that during the follow up of aplastic anemia patients, PNH clones were developed. So, we investigated the usefulness of newly introduced CD55 and CD59 tests for the diagnosis of PNH compared with conventional tests and the significance of previous history of aplastic anemia in PNH patients.
METHODS
We performed the flow cytometric measurements with indirect immunofluorescence method using monoclonal antibodies to each CD55 or CD59 on the surface of red cells or neutrophils. Among fifty one patients who were requested of CD55 and CD59 tests, we reviewed the medical records of ten patients who showed the defective expression of CD55 and/or CD59 expression.
RESULTS
Of ten patients who showed the defective expression of CD55 and/or CD59 expression on red cells or neutrophils, six patients were requested of sucrose lysis test also and seven patients Ham's test. Only three of six (50%) showed positive results in sucrose lysis test and two of seven (29%) in Ham's test. One showed detective CD59 expression on only neutrophils. Four (40%) had the history of aplastic anemia and two (20%) were diagnosed as aplastic anemia and PNH at the same time. Another one had the refractory anemia of excess blasts and another acute mixed lineage leukemia at the time of CD55 and CD59 tests. Two were diagnosed as PNH in the course of cytopenia workup and had no previous history of hematologic diseases.
CONCLUSION
CD55 and CD59 tests are considered to be the most useful and specific tests to diagnose PNH. During the follow up of patients with aplastic anemia, CD55 and CD59 tests are valuable to detect the development of complicated PNH clones.
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