Paroxysmal nocturnal hemoglobinuria physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

Patients with paroxysmal nocturnal hemoglobinuria usually appear tired. Physical examination of patients with PNH is usually remarkable for fever, skin pallor, skin ecchymoses and skin nodules. Physical examination may show abdominal distension if PNH is associated with Budd-Chiari syndrome.

Physical Examination

Appearance of the Patient

• Patients with paroxysmal nocturnal hemoglobinuria usually appear tired.

Vital Signs

• Fever may be present due to infections

Skin

• Pallor
• Skin ecchymoses
• Skin nodules if it is associated with dermal vein thrombosis

HEENT

• HEENT examination of patients with paroxysmal nocturnal hemoglobinuria is usually normal.

Neck

• Neck examination of patients with paroxysmal nocturnal hemoglobinuria is usually normal.

Lungs

• Pulmonary examination of patients with paroxysmal nocturnal hemoglobinuria is usually normal.

Heart

• Cardiovascular examination of patients with paroxysmal nocturnal hemoglobinuria is usually normal.

Abdomen

• Abdominal distention if associated with Budd-Chiari syndrome
• Hepatomegaly
• Splenomegaly

Genitourinary

• Genitourinary examination of patients with paroxysmal nocturnal hemoglobinuria is usually normal.