Management of paroxysmal nocturnal hemoglobinuria with low-level hemolysis in pregnancy– a report of two cases

Published on 04/11/2025

Reading time: 3 min.

Riedl Julia ¹, Pfeilstöcker Michael ², Farr Alex ³, Häusler Günther ³, Ay Cihan ¹, Füreder Wolfgang ¹

¹ https://ror.org/05n3x4p02 Department of Medicine I, Division of Hematology & Hemostaseology Medical University of Vienna Vienna Austria
² https://ror.org/0163qhr63 3rd Medical Department for Hematology and Oncology Hanusch Hospital Vienna Austria
³ https://ror.org/05n3x4p02 Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Comprehensive Center for Pediatrics (CCP) Medical University of Vienna Vienna Austria

Abstract

Pregnant women with paroxysmal nocturnal hemoglobinuria (PNH) are at high risk for life-threatening thromboembolism. Therapy with the complement inhibitor eculizumab is able to mitigate thrombotic risks in PNH and to improve pregnancy outcomes. However, whether PNH with low-level hemolysis in pregnancy can be safely managed without complement inhibition is unclear.

Here, we describe two pregnant patients with PNH in the setting of bone marrow failure and low-level hemolysis...

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