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Myelodysplastic syndrome mimicking idiopathic thrombocytopenic purpura

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hwang, Yusun Huh, Jung Won Mun, Yeung Chul Seong, Chu Myong Chung, Wha Soon
Description	Author Affiliation: Hwang Y ( Department of Laboratory Medicine, Division of Hematology-Oncology, Ewha Womans University School of Medicine, Seoul, Korea.)
Abstract	BACKGROUND: In patients with isolated thrombocytopenia, but without significant dysplasia, diagnosis of idiopathic thrombocytopenic purpura (ITP) rather than myelodysplastic syndrome (MDS) may be taken into account. It is important to make an accurate diagnosis because different treatments are used for ITP and MDS. The purpose of this study was to investigate the clinical and hematologic features of patients who were initially diagnosed as ITP but had cytogenetic abnormalities. METHODS: We retrospectively reviewed cytogenetic studies of 100 patients who were diagnosed as ITP from 2004 to 2009 at Mokdong Hospital of Ewha Womans University based on clinical features and hematologic studies. Bone marrow pathology was re-evaluated based on 2008 WHO classification. Cytogenetic analysis was performed by 24-48 hr culture of bone marrow aspirates without using mitogens and 20 metaphases were analyzed. RESULTS: Of the 100 patients diagnosed as ITP initially, three patients (3%) had cytogenetic abnormalities. They had no thrombocytopenia-related symptoms and thrombocytopenia was found accidentally. The numbers of megakaryocytes in bone marrow were increased and dysplasia was not found in megakaryocyte, erythroid, and myeloid cell lineages. The proportion of blasts was within normal limits. Clonal chromosomal abnormalities found were der(1;7)(q10;p10), add(9)(q12), or t(7;11)(p22;q12). Presumptive diagnosis of MDS or diagnosis of idiopathic cytopenia of undetermined significance (ICUS) was made according to 2008 WHO classification. During the follow up, disease progression was not found. CONCLUSIONS: In patients with suspected ITP, cytogenetic analysis should be done. If specific clonal chromosomal abnormality is found, presumptive diagnosis of MDS has to be considered and close follow up is needed.
File Format	HTM / HTML
ISSN	22343806
e-ISSN	22343814
Journal	The Korean Journal of Laboratory Medicine
Issue Number	2
Volume Number	30
Language	Korean
Publisher	Korean Society for Laboratory Medicine
Publisher Date	2010-04-01
Publisher Place	Korea (South)
Access Restriction	Open
Subject Keyword	Discipline Medical Laboratory Technology Myelodysplastic Syndromes Diagnosis Purpura, Thrombocytopenic, Idiopathic Bone Marrow Cells Cytology Cell Lineage Chromosome Aberrations Diagnosis, Differential Megakaryocytes Immunology Pathology Genetics Retrospective Studies
Content Type	Text
Resource Type	Case study Article
Subject	Biochemistry (medical) Clinical Biochemistry

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