This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Blood, Subject name: Medicine
True in a patient with PNH? 
Select and explain. 
A. Splenomegaly is commonly present, B. Aplastic anaemia is a recognized complication, C. Chronic granulocytic leukemia may supervene, D. The Hess test is commonly abnormal
B: Aplastic anaemia is a recognized complication
Answer: B: Aplastic anaemia is a recognized complication 
Explanation: Ans. B. Aplastic anaemia is a recognized complicationa. Iron may indeed precipitate Haemolysis and this is a not uncommon presenting feature. The mechanism may be due to increased output of complement sensitive reticulocytes following iron treatment in patients with marginal iron balance.b. Aplastic anaemia may supervene but there is no association with chronic granulocytic leukaemia.c. The Ham's acidified serum test is positive in PNH but the Hess test is not commonly abnormal unless thrombocytopenia occurs due to progressive aplasia. Splenomegaly is unusual.