Use of intravenous immunoglobulin in the treatment of paroxysmal nocturnal hemoglobinuria: a case report and literature review

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal disorder of hematopoietic stem cell (HSC) that makes blood cells more sensitive to active complement system. Eculizumab is considered as primary treatment for PNH nowadays. Because of the commercial unavailability of eculizumab in China, the treatment is still at a conventional level, such as using steroid and blood transfusion. However, PNH treated with intravenous immunoglobulin (IVIG) has never been reported. Here, we reported a patient treated with IVIG and got better therapeutic effects, presenting with obviously improved hemoglobin and dropped lactate dehydrogenase (LDH) close to normal level after IVIG. We think IVIG for PNH is worth being concerned and verified as an alternative therapy when eculizumab is not in hand.