title: [Paroxysmal nocturnal hemoglobinuria (PNH)].
abstract: Paroxysmal nocturnal hemoglobinuria is an acquired hematopoietic stem cell disorder. The most common clinical manifestations of PNH include intravascular hemolysis, venous thrombosis, and bone marrow failure. Hematopoietic stems cells with mutant PIG-A are present in normal marrow, but they are not noticed because they have no advantage under normal circumstances. In the setting of immune-mediated bone marrow injury, such as that seen in aplastic anemia, PIG-A mutant cells are selected because they have a survival advantage based on deficiency of one or more GPI-anchored proteins. Expansion of the PIG-A-mutant clones occurs when other events that enhance the growth properties of the cells work together with the effects of the PIG-A mutation to enhance further the growth properties of the mutant cells.
authors.affiliation: Department of Hematology and Oncology, Osaka University Graduate School of Medicine.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Nishimura
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kanakura
mesh_terms: D000818:Animals; D001854:Bone Marrow Cells / Q000473:pathology; D018797:Cell Cycle Proteins / Q000235:genetics; D002999:Clone Cells / Q000473:pathology; D025743:HMGA2 Protein / Q000235:genetics; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006457:Hemoglobinuria, Paroxysmal / Q000235:genetics / Q000473:pathology; D006801:Humans; D008565:Membrane Proteins / Q000235:genetics*; D035683:MicroRNAs / Q000235:genetics; D009154:Mutation
chemical_list: C486562:CAPRIN1 protein, human; D018797:Cell Cycle Proteins; D025743:HMGA2 Protein; D008565:Membrane Proteins; D035683:MicroRNAs; C487931:mirnlet7 microRNA, human; C080086:phosphatidylinositol glycan-class A protein