Step 1: Paroxysmal nocturnal haemoglobinuria (PNH) is caused by an acquired mutation in the PIGA gene, which is required to make the glycosylphosphatidylinositol (GPI) anchor.
Step 2: Without the GPI anchor, surface proteins that depend on it are lost. Two of these are the complement-regulatory proteins CD55 (DAF) and CD59 (MIRL).
Step 3: Loss of CD55 and CD59 leaves red cells unprotected against complement, causing complement-mediated intravascular haemolysis. Flow cytometry showing deficient CD59 and CD55 on blood cells is the definitive diagnostic test for PNH. Hence the answer is PNH.
Step 4: The distractors are unrelated: PTEN is a tumour-suppressor gene, and Cowden syndrome and BRR (Bannayan-Riley-Ruvalcaba) are PTEN-related hamartoma syndromes, not CD59-defined disorders.