Glucocorticoid-induced thrombotic microangiopathy in paroxysmal nocturnal hemoglobinuria: A case report and review of literature

Figure 2 Sequential hematological changes following initiation and discontinuation of glucocorticoid treatment. Following initiation of methylprednisolone treatment, the hemoglobin levels (Hb ×10 g/L) and platelet counts (Plt × 10 × 10⁹/L) rapidly decreased, together with a decrease in white blood cells (WBC ×10⁹/L) and an increase in absolute reticulocyte count (Ret × 10 × 10⁹/L). Increasing the methylprednisolone dose after hospitalization resulted in the worsening of platelet consumption and intravenous hemolysis. Discontinuation of methylprednisolone treatment showed significant hematological improvement with restoration of hemoglobin levels and platelet counts similar to those prior to methylprednisolone treatment.