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Dave RV, Cheung S, Sibbering M, Kearins O, Jenkins J, Gandhi A. Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer. BJS Open 2020; 5:6024956. [PMID: 33688940 PMCID: PMC7944503 DOI: 10.1093/bjsopen/zraa022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/11/2020] [Indexed: 01/28/2023] Open
Abstract
Background Women with screen-detected invasive breast cancer who have macrometastatic disease on axillary sentinel lymph node biopsy (SLNB) are usually offered either surgical axillary node clearance (ANC) or axillary radiotherapy. These treatments can lead to significant complications for patients. The aim of this study was to identify a group of patients who may not require completion ANC. Methods Data from the NHS Breast Screening Programme between 1 April 2012 and 31 March 2017 were interrogated to identify women with invasive breast carcinoma and a single sentinel lymph node (SLN) with macrometastatic disease who subsequently proceeded to completion ANC. Univariable and multivariable analyses were performed to identify patients with a single positive SLN who had no further lymph node metastasis on ANC. Results Of the 2401 women included in the cohort, the presence of non-sentinel node disease was significantly affected by: the number of nodes obtained at SLNB (odds ratio (OR) 0.49 for retrieval of more than 1 node), invasive size of tumour (OR 1.63 for size greater than 20 mm), surgical treatment (OR 1.34 for mastectomy), human epidermal growth factor receptor (HER) 2 status (OR 0.71 for HER2 positivity), and patient age (OR 1.10 for age less than 50 years; OR 1.46 for age greater than 70 years). Patients aged less than 70 years, with tumour size smaller than 2 cm, more than one node retrieved on SLNB, and who had breast-conserving surgery had a lower chance of positive non-sentinel nodes on completion ANC compared with other patients. Conclusion This study, of a purely screen-detected breast cancer cohort, identified a subset of patients who may be spared completion ANC in the event of a single axillary SLN with macrometastasis.
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Phogat V, Gandhi A, Srivastava T, Mishva K. Endovascular management of intracranial pseudoaneurysm: an institutional experience. J Cerebrovasc Endovasc Neurosurg 2020; 22:211-215. [PMID: 33207401 PMCID: PMC7820270 DOI: 10.7461/jcen.2020.e2019.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/15/2020] [Indexed: 12/30/2022] Open
Abstract
Objective Pseudoaneurysms (PSAs) of the internal carotid artery (ICA) and vertebral artery are rare entities but with varied treatment options. PSAs can be spontaneous or secondary to trauma, infections, malignancies or iatrogenic. To find out the efficacy of various endovascular interventions in the management of ICA and vertebral PSAs. Methods The study included 14 patients diagnosed with intracranial PSAs who underwent endovascular interventions in SMS Medical College, Jaipur (Rajasthan) between June 2015 to January 2019. The clinical and radiological findings (computed tomography angiography and digital subtraction angiography) were reviewed and the consequent endovascular intervention carried out and their results were analyzed. Results Total 14 patients were studied out of which 8 (57.1%) were anterior circulation PSAs and 6 (42.9%) were posterior circulation PSAs There were 10 (71.4%) females and 4 (28.5%) males between the age of 9 to 65 years. Only 2 patients with PSA had past history of trauma. Coiling was done in 8 patients (57.1%), stenting in 2 patients (14.2%), parent artery occlusion in 1 patient (7.1%), glue embolization in 1 patient (7.1%) while coiling with glue in 1 patient (7.1%) and flow diverter in 2 patients (14.2%). Immediate and complete occlusion was achieved in 11 (78.6%) patients while 3 (21.4%) patients had subtotal occlusion. 11 patients under follow up till June 2019 did not report recurrence or new neurological deficit. Conclusions Endovascular interventions is minimally invasive and safe treatment strategy for intracranial PSAs. The ultimate choice of technique depends on clinical and imaging characteristics.
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Hile E, Valente A, Gandhi A, Xu C, Neuhold R, Moore K. Gait speed change during first chemotherapy cycle may predict later dose-reduction in ovarian cancer patients over 70: An exploratory analysis. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jain S, Mishra K, Gandhi A, Garg D. Curious Case of Atypical Hangman’s Fracture: C2–C3 Listhesis without Pars Fracture. J Neurosci Rural Pract 2020; 11:663-666. [PMID: 33144811 PMCID: PMC7595777 DOI: 10.1055/s-0040-1716988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Traumatic spondylolisthesis of axis or hangman’s fracture is the second most common C2 vertebra injury. We present a report of a young man presenting with a history of fall from height with C2 to C3 spondylolisthesis without any evidence of injury to pars interarticularis but with associated injury to capsular ligament of facet joint along with posterior spinous ligamentous injury. The patient underwent intraoperative reduction in listhesis with posterior screw fixation. The patient showed uneventful postoperative course with neurological improvement at 6-week follow-up. Hangman’s fracture refers to a diverse group of injury in which the soft tissue injury has an equally important part to play as the bone fracture.
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Hile E, Valente A, Gandhi A, Neuhold R, Xu C, Moore K. Mobility-related basic and instrumental activities of daily living fluctuate over 2-3 cycles of chemotherapy for ovarian cancer in women over 70: An exploratory analysis. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gandhi A, Barhate MV, Jain SK, Gandhi SA. Cushing’s Disease due to ACTH Secreting Pituitary Microadenoma: A Single Institutional Experience of Four Cases. INDIAN JOURNAL OF NEUROSURGERY 2020. [DOI: 10.1055/s-0040-1713333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractACTH secreting pituitary adenomas are rare occurrences in autoptical, surgical and neuroradiological series. We herewith describe a series of four patients of Cushing’s disease due to ACTH secreting pituitary microadenoma. All patients presented with signs and symptoms of hypercortisolism. Hormonal testing and bilateral inferior petrosal sinus sampling were indicative of pituitary-dependent Cushing’s syndrome. Dynamic sellar MRI was suggestive of asymmetric pituitary, with suspect pituitary microadenoma in all cases. Three patients were operated for endoscopic endonasal transsphenoidal surgery, while one patient refused surgery and was managed with ketoconazole. During postoperative period, remission of hypercortisolism was ensured in two patients, while one patient continued to have raised levels of cortisol. One patient with raised levels of cortisol during postoperative period was prescribed Ketoconazole for 6 months. Histopathology confirmed the presence of pituitary adenoma. Adenoma displayed ACTH immunoreactivity. Our cases indicate that ACTH secreting pituitary microadenoma may occur in patients with Cushing’s disease. Careful radiological, surgical and pathological examination is necessary to recognize this condition and avoid surgical failure.
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Masand VH, Rastija V, Patil MK, Gandhi A, Chapolikar A. Extending the identification of structural features responsible for anti-SARS-CoV activity of peptide-type compounds using QSAR modelling. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2020; 31:643-654. [PMID: 32847369 DOI: 10.1080/1062936x.2020.1784271] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
A quantitative structure-activity relationship (QSAR) model was built from a dataset of 54 peptide-type compounds as SARS-CoV inhibitors. The analysis was executed to identify prominent and hidden structural features that govern anti-SARS-CoV activity. The QSAR model was derived from the genetic algorithm-multi-linear regression (GA-MLR) methodology. This resulted in the generation of a statistically robust and highly predictive model. In addition, it satisfied the OECD principles for QSAR validation. The model was validated thoroughly and fulfilled the threshold values of a battery of statistical parameters (e.g. r 2 = 0.87, Q 2 loo = 0.82). The derived model is successful in identifying many atom-pairs as important structural features that govern the anti-SARS-CoV activity of peptide-type compounds. The newly developed model has a good balance of descriptive and statistical approaches. Consequently, the present work is useful for future modifications of peptide-type compounds for SARS-CoV and SARS-CoV-2 activity.
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Kamali A, Sullivan KC, Rahmani F, Gandhi A, Aein A, Arevalo O, Rabiei P, Choi SJ, Zhang X, Gabr RE, Riascos RF. Indentation and Transverse Diameter of the Meckel Cave: Imaging Markers to Diagnose Idiopathic Intracranial Hypertension. AJNR Am J Neuroradiol 2020; 41:1487-1494. [PMID: 32763895 DOI: 10.3174/ajnr.a6682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 05/19/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Clinical and imaging manifestations of idiopathic intracranial hypertension should prompt early diagnosis and treatment to avoid complications. Multiple diagnostic imaging criteria are reported to suggest the diagnosis of idiopathic intracranial hypertension with questionable sensitivity and/or specificity. Increased intracranial pressure results in dilation of the perineural cisternal spaces such as the optic nerve sheaths and the Meckel cave. It may also cause protrusion of cisternal structures of the Meckel cave through the skull base foramina, which could result in indentation or a bilobed appearance of the Meckel cave. We investigated the changes in the Meckel cave in patients with proved idiopathic intracranial hypertension versus healthy controls. MATERIALS AND METHODS We studied 75 patients with a diagnosis of idiopathic intracranial hypertension and 75 age-and sex-matched healthy controls. The transverse diameter of Meckel cave was measured in the axial and coronal planes of T2-weighted MR imaging sequences, and comparison was made between the 2 groups. RESULTS The mean diameters of the Meckel cave on the coronal T2 plane in patients with idiopathic intracranial hypertension were 5.21 ± 1.22 mm on the right side and 5.16 ± 0.90 mm on the left side, while in the control group, they measured 3.89 ± 0.62 mm and 4.09 ± 0.68 mm, respectively (P value < .001). Of 75 patients with an approved diagnosis of idiopathic intracranial hypertension, 57 (76%) showed an indented Meckel cave as opposed to 21 (28%) in the control group. CONCLUSIONS Our results confirm for the first time that the shape and size of the Meckel cave can be used as sensitive and specific diagnostic imaging markers for the diagnosis of idiopathic intracranial hypertension.
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Gandhi A, Doughty J. Comment on: Management of the axilla following neoadjuvant chemotherapy for breast cancer. Br J Surg 2019; 106:1705. [PMID: 31639210 DOI: 10.1002/bjs.11415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 11/08/2022]
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Vandenbroucke T, Verheecke M, van Gerwen M, Van Calsteren K, Halaska M, Fumagalli M, Fruscio R, Veening M, Lagae L, Ottevanger P, Voigt JU, de Haan J, Gziri M, Gandhi A, Maggen C, Mertens L, Naulaers G, Claes L, Amant F. Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mallen A, Townsend M, Boac B, Todd S, Gandhi A, Kuznicki M, Magliocco A, Fridley B, Tworoger S, Vadaparampil S, Wenham R. Predictive factors of genetic referral for advanced, epithelial ovarian cancer patients at a Single-Institution Cancer Center. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zavras PD, Wang Y, Gandhi A, Lontos K, Delgoffe GM. Evaluating tisagenlecleucel and its potential in the treatment of relapsed or refractory diffuse large B cell lymphoma: evidence to date. Onco Targets Ther 2019; 12:4543-4554. [PMID: 31354288 PMCID: PMC6572744 DOI: 10.2147/ott.s177844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/29/2019] [Indexed: 12/19/2022] Open
Abstract
Chimeric antigen receptor (CAR) T cells have changed the treatment landscape of relapsed or refractory diffuse large B cell lymphoma. This review focuses on the biology of tisagenlecleucel and the clinical data that support its use in this setting. In addition, we discuss how it compares to other CAR T products, the financial implications for payers, and ongoing trials.
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Gandhi A, Terrin M, Costa N, Young R, Wijesinha M, Vesselinov R, Young C, Kaczorowski D, Madathil R, Griffith B, Thomas B, Iacono A, Timofte I. Sirolimus Based Immunosuppression Regimen after Lung Transplantation Can Decrease CNI Related Nephrotoxicity. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Timofte I, Terrin M, Gandhi A, Yang R, Wijesinha M, Vesselinov R, McLaughlin P, Costa N, Kaczorowski D, Madathil R, Griffith B, Iacono A. Inhaled Cyclosporine-Based Immunosuppression Regimen for Lung Transplant Associated Malignancy. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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40
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Shah R, Gandhi A, Mistry Y. Experience of sentinel lymph node biopsy (SLNB) with Tc99 & gamma probe in early breast cancer – its cost, accuracy, complications in Kailash Cancer Hospital & Research Centre in rural India. Breast 2019. [DOI: 10.1016/s0960-9776(19)30382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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41
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Verma A, Yadav B, Gandhi A, Kumar E, Thorve S, Soni R. Pipe stress analysis of first wall helium cooling system for conceptual design development of IN LLCB TBM. FUSION ENGINEERING AND DESIGN 2018. [DOI: 10.1016/j.fusengdes.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Verma P, Gandhi A, Kumar P, Jain S. Oyster calcification of infected bone flap: A rare complication. Asian J Neurosurg 2018; 13:797-799. [PMID: 30283550 PMCID: PMC6159056 DOI: 10.4103/ajns.ajns_237_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An extremely rare case of chronic epidural empyema after cranioplasty is presented. It derives its extreme rareness from its association with calcification. This patient when presented to our department had a complaint of swelling with on and off discharging sinus for 2 months adjacent to old incision scar mark. The patient had a history of decompressive craniectomy and evacuation of acute subdural hematoma, in some other institution, 8 years back. Following that, the patient underwent cranioplasty with the exteriorized and preserved bone flap. In the meantime, he was asymptomatic. It is a unique interesting case of chronic epidural empyema with calcified walls after 8 years of long duration following cranioplasty.
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Pinder S, Shaaban A, Deb R, Desai A, Gandhi A, Lee A, Pain S, Wilkinson L, Sharma N. NHS Breast Screening multidisciplinary working group guidelines for the diagnosis and management of breast lesions of uncertain malignant potential on core biopsy (B3 lesions). Clin Radiol 2018; 73:682-692. [DOI: 10.1016/j.crad.2018.04.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/11/2018] [Indexed: 10/28/2022]
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Ansari A, Gandhi A, Mittal R, Sharma A. Pseudo primary abscess of the cavum septum pellucidum due to pus entrapment: A rare case report. Asian J Neurosurg 2018; 13:394-395. [PMID: 29682041 PMCID: PMC5898112 DOI: 10.4103/1793-5482.228514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The cavum septum pellucidum (CSP) is defined as a crevice-like space of variable width between the left and right transparent septum. In this report, a rare case of pseudo primary abscess formed in the CSP due to ventriculitis is presented.
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Srivastava T, Husain S, Gandhi A, Sinha V. Endovascular Occlusion of Traumatic Carotid Cavernous Fistula by Using Detachable Balloon in Various Ways: A Case Series. INDIAN JOURNAL OF NEUROTRAUMA 2018. [DOI: 10.1055/s-0037-1616034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Abstract
Introduction The detachable balloons are not frequently used nowadays for endovascular occlusion of carotid-cavernous fistula (CCF) because of lack of availability and supposed high risk of recurrence. This study describes the various way of detachable balloon embolization for traumatic CCF.
Materials and Methods We have used endovascular detachable balloon to occlude the traumatic CCF under local anesthesia in various ways in 12 traumatic cases of CCF from March 2013 to April 2015. Clinical and computed tomographic (CT) angiography follow-up was done at 6 and 12 months.
Results Clinical follow-up from 6 to 12 month showed persistent resolution of symptoms in 10 cases; 2 cases had developed slight proptosis and chemosis. CT angiography done in nine cases after 6 to 9 months showed no residual filling in CCF.
Conclusion The detachable balloon either single or double with or without coils can be used in the management of CCF by different methods. Detachable balloon is a cheaper alternative compared with coiling. It is technically easier to perform and can be performed under local anesthesia.
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Khan KA, Gandhi A, Sharma V, Jain S. Penetrating head injury due to angle grinder: an occupational hazard. Br J Neurosurg 2018; 33:202-206. [DOI: 10.1080/02688697.2018.1467375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Shah P, Rohly M, Brown A, Timofte I, Nayyar M, Gandhi A, Kim N, Joshi A, Iacono A, Nathan S, Avery R, Orens J, Agbor-Enoh S, Valantine H. Donor Derived Cell Free DNA is Elevated With Pathogens That are Risk Factors For Chronic Lung Allograft Dysfunction. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Fedorov N, Grozdanov D, Bystritskiy V, Kopach Y, Ruskov I, Skoy V, Tretyakova T, Zamyatin N, Wang D, Aliev F, Hramco C, Gandhi A, Kumar A, Dabylova S, Bogolubov E, Barmakov Y. Measurements of the gamma-quanta angular distributions emitted from neutron inelastic scattering on 28Si. EPJ WEB OF CONFERENCES 2018. [DOI: 10.1051/epjconf/201817702002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The characteristic gamma radiation from the interaction of 14.1 MeV neutrons with a natural silicon sample is investigated with Tagged Neutron Method (TNM). The anisotropy of gamma-ray emission of 1.779 MeV was measured at 11 azimuth angles with a step of ∠15°. The present results are in good agreement with some recent experimental data.
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Yadav B, Gandhi A, Verma A, Sandeep K, Chaudhari V, Kumar ER. Helium cooling systems for Indian LLCB TBM testing in ITER. FUSION ENGINEERING AND DESIGN 2017. [DOI: 10.1016/j.fusengdes.2017.05.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Puri V, Gandhi A, Sharma S. Renal Biopsy in Paroxysmal Nocturnal Hemoglobinuria: An Insight into the Spectrum of Morphologic Changes. Indian J Nephrol 2017; 27:284-288. [PMID: 28761230 PMCID: PMC5514824 DOI: 10.4103/0971-4065.202833] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired, potentially life-threatening disease of blood, characterized by complement-induced intravascular hemolytic anemia and thrombosis. PNH can sometimes present directly with renal manifestations, without showing any hematological manifestation. It, therefore, becomes essential for clinicians and pathologists to be aware of the spectrum of renal changes in PNH. The aim of this study was to document the morphologic changes observed in renal biopsies in patients with PNH. This is an observational study. We report three cases that presented with acute or chronic renal insufficiency and were suspected as PNH on viewing their renal biopsy in light of their clinical and laboratory details. All the three cases were confirmed as PNH on the basis of flow cytometric analysis of CD55 and CD59. Renal biopsy in these patients showed a variety of morphologic changes, however the most consistent finding was moderate-to-heavy siderosis in their kidneys. PNH per se may be difficult to diagnose clinically and sometimes present directly with renal manifestations. It is, therefore, prudent for nephrologists and nephropathologists to be aware of the spectrum of renal changes in PNH.
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