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Myelodysplastic syndrome mimicking idiopathic thrombocytopenic purpura

Title
Myelodysplastic syndrome mimicking idiopathic thrombocytopenic purpura
Authors
Hwang Y.Huh J.-W.Mun Y.-C.Seong C.-M.Chung W.S.
Ewha Authors
정화순성주명허정원문영철
SCOPUS Author ID
정화순scopus; 성주명scopus; 허정원scopus; 문영철scopus
Issue Date
2010
Journal Title
Korean Journal of Laboratory Medicine
ISSN
1598-6535JCR Link
Citation
vol. 30, no. 2, pp. 105 - 110
Indexed
SCOPUS WOS scopus
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.
DOI
10.3343/kjlm.2010.30.2.105
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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