Muscular exercise in patients with paroxysmal nocturnal hemoglobinuria has been shown to result in systemic acidosis with lacticacidemia and exacerbation of in vivo hemolysis. It is suggested on the basis of this study that patients with PNH be advised to avoid severe muscular exercise.

The acid hemolysis test should be performed in all patients that are suspected of having March hemoglobinuria.

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