16th February 2024

A 26-year-old female presents to the unit with intermittent dark-coloured urine that has persisted for the past two weeks

A 26-year-old female presents to the unit with intermittent dark-coloured urine that has persisted for the past two weeks. The hematuria is worse in the mornings. This is accompanied by yellowing of her sclera and abdominal pain over the past four days. Her renal ultrasound was normal, with urinalysis ruling out a UTI. Blood tests revealed low Hb, WCC and platelets with raised LDH and haptoglobin levels. The direct Coombs test was negative. Flow cytometry shows reduced expression of CD55 and CD59 on red blood cells.

What is the underlying diagnosis?

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