What is one of the most serious outcomes of untreated autoimmune hemolytic anemia associated with paroxysmal nocturnal hemoglobinuria?

Untreated autoimmune hemolytic anemia associated with paroxysmal nocturnal hemoglobinuria (PNH) can lead to the development of thrombosis, which is a serious and potentially life-threatening complication. PNH is characterized by the destruction of red blood cells due to the absence of protective proteins on the surface of the cells, leading to hemolysis.

In PNH, there is a particularly high risk of developing thrombosis, especially in the venous system. This phenomenon is thought to relate to the increased blood viscosity and the release of procoagulant factors from the hemolyzed red blood cells, as well as the role of complement activation, which can cause endothelial damage. The most frequently observed thrombotic events in PNH occur in the hepatic, portal, and cerebral veins, and these complications can lead to significant morbidity and mortality.

While anemia, jaundice, and infection are important considerations in the context of PNH and autoimmune hemolytic anemia, they do not represent the most severe immediate threat to the patient's health. Anemia itself is a consequence of the hemolysis that can be managed, jaundice is a symptom of hemolysis and can present in various degrees without immediate danger, and while infection risk can