<s>[INST] I am a 19-year-old female from Africa. I have intermittent episodes of Coca cola colored urine, abdominal pain, trouble swallowing, headache and sometimes blurry vision. My IgG levels are over 2,200 and my IgG1 in particular is elevated. I had a test that was equivocal for Paroxysmal Nocturnal Hemoglobinuria. I also have Iron deficiency anemia and get regular intravenous iron infusions. This has been going on for a year. My hematologist seems to have given up trying to get a diagnosis because the test was equivocal. What should I do. [/INST] Hi. Thanks for your query and an elucidated history. Obviously go for repeat tests and second opinion of another Hematologist. The history is suggestive of hemoglobinuria. Another possibility is of Porphyria. In this condition you get almost similar symptoms and pathology. The Urine is kept in a glass bottle and exposed to sun-rays for a day to see whether it is turned into the brown color or not. The treatment is obviously symptomatic, to take plenty of oral fluids as the detailed to be followed as per the advice of a Hematologist. Another opinion of a Urologist may help  </s>