Khaleduzzaman HM¹* and Mishu Nafisa Jabin²

¹MBBS, FCPS (Medicine), MACP, Bangladesh
²MBBS, M-Phil (Microbiology), Bangladesh

*Corresponding Author: Khaleduzzaman HM, MBBS, FCPS (Medicine), MACP, Bangladesh.

Received: March 16, 2022; Published: May 11, 2022

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS COV-2) activate and enhances complement mediated cell destruction through membrane attack complex (MAC) formation (Ting Gao, 2020) [6]. In paroxysmal nocturnal hemoglobinuria (PNH) there is deficiency of complement regulatory proteins (CD55 and CD59) which enhances the red blood cells (RBC) to lysis by MAC (Rother, 2005) [3]. SARS COV-2 causes complement activation on the other hand individuals with PNH is vulnerable to complement mediated destruction of RBC. In PNH when massive hemolysis occur hemosiderin become deposited in renal tubule causing acute renal tubular necrosis (ATN). If it is diagnosed and treated early it may be reversible but if remain untreated it may progress to chronic kidney disease (CKD) as occur in this patient (Hussain S, 2013) [1]. Individual with PNH when superadded with COVID-19 infection it should be treated with extreme caution to prevent multiple complications.

Keywords: PNH; COVID-19; CKD; Eculizumab; Hb E Trait

References

1. Hussain SQA. “Renal Involvement in Paroxysmal Nocturnal Hemoglobinuria”. Nephron Clinical Practice (2013): 28-35.
2. Orkin SH K H. “Abnormal RNA processing due to the exon mutation of beta E-globin gene”. Nature (1982): 768-769.
3. Rother R P. "The clinical sequelae of intravascular hemolysis and extracellular plasma hemoglobin: a novel mechanism of human disease.". JAMA13 (2005): 1653-1662.
4. Staurt H Ralston I D. “Davidson'S Principle and Practice of Medicine”. New York: ELSEVIER (2018).
5. Suthat Fucharoen D J. “The Hemoglobin E Thalassemias”. Cold Spring Harbor Perspectives in Medicine 8 (2012).
6. Ting Gao MH. “Highly pathogenic coronavirus N protein aggravates lung injury by MASP-2-mediated complement over-activation”. medRxiv (2020): 1-4.

Citation

Citation: Khaleduzzaman HM and Mishu Nafisa Jabin. “COVID-19 Infection in a Patient with Paroxysmal Nocturnal Hemoglobinuria". Acta Scientific Medical Sciences 6.6 (2022): 133-135.

Copyright

Copyright: © 2022 Khaleduzzaman HM and Mishu Nafisa Jabin. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.