What mechanism causes "Paroxysmal nocturnal hemoglobinuria" mostly occurs at nights? - USMLE Forums
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Old 10-10-2011
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Default What mechanism causes "Paroxysmal nocturnal hemoglobinuria" mostly occurs at nights?

I understand the "Paroxysmal nocturnal hemoglobinuria" is not autoimmune disease but due to defective stem cells which are hypersensitive to complement mediated lysis to all hematopoietic cells (all myeloid linages). But can anyone explain why it happens mostly at nights?
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Old 10-10-2011
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At night during sleep, you have a slight hypercapnia occurring. The result of the increased CO2 is a decrease in PH. This somehow makes complement more active and thus you have the hemolysis of this disease.
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HaipengWang (10-11-2011)
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Old 10-10-2011
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well thats old knowledge!

its actually a misnomer.....it occurs throughout the day...but we notice it more in the morning pee coz the renal blood flow increases more while sleeping!
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