<s>[INST] context: Clinical features of PNH
A. Intravascular hemolysis

The main feature of PNI-I is increased intravascular hemolysis that results in



Hemoglobinemia           


Hemoglobinuria              


Hemosiderinuria


Increased urine urobilinogen  


Decreased serum haptoglobin 


Increased serum LDH          


Increased serum bilirubin



The hemolysis is paroxysmal and usually occurs in the night because during sleep the pH of blood gets slightly reduced and acidic medium leads to activation of the complement.

B. Thrombosis

In PNH there is episodic thrombosis due to the absence of CD-59 on platelets, this results in the externalization of phosphatidylserine, a site for prothrombinase complexes and thus increase the propensity for thrombosis.
Intrabdominal veins are the most common sites of thrombosis that may result in Budd Chiari syndrome due to hepatic vein thrombosis.

C. Other features

Thrombocytopenia
Granulocytopenia
Decreased LAP score
Normoblastic hyperplasia of bone marrow
PNH patients are also at increased risk for developing acute myelogenous leukemia and aplastic anemia. [/INST] question: Which is not a feature of paroxysmal nocturnal hemoglobinuria - | options: A: Increased LAP score B: Thrombosis C: Thrombocytopenia D: Hemolysis | answer: A </s>