The morphology of erythrocytes from 4 patients with paroxysmal nocturnal hemoglobinuria (PNH) was studied by scanning electron microscope (SEM). A great variability in shape and size of red cells was observed; many red cells showed protuberances raising from the central depression or from the rim. On the surface of the more irregular cells, pits, craters and depressions were present. Although these findings are not specific for PNH and the creation of artifacts during specimen preparation for SEM is very easy, they can be an expression of the basic structural defect of PNH red cell membrane.
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