Unusual Myelodysplastic Syndrome with the Initial Presentation Mimicking Idiopathic Thrombocytopenic Purpura

2002 ◽  
Vol 108 (3) ◽  
pp. 139-143 ◽  
Author(s):  
Junya Kuroda ◽  
Shinya Kimura ◽  
Yutaka Kobayashi ◽  
Katsuya Wada ◽  
Nobuhiko Uoshima ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Initial Presentation ◽  
Thrombocytopenic Purpura

scholarly journals A Case of Refractory Thrombocytopenia with 5q Deletion: Myelodysplastic Syndrome Mimicking Idiopathic Thrombocytopenic Purpura

2014 ◽  
Vol 34 (6) ◽  
pp. 466-468
Author(s):  
Jeonghyun Chang ◽  
Chan-Jeoung Park ◽  
Eul-Ju Seo ◽  
Jung-Hee Lee ◽  
Sang Hyuk Park ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Thrombocytopenic Purpura ◽  
5Q Deletion

Immature Platelet Fraction in Different Diagnosis of Thrombocytopenic States: An Approach to Distinguish Idiopathic Thrombocytopenic Purpura from Myelodysplastic Syndrome with Isolated Thrombocytopenia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1085-1085
Author(s):  
Koji Miyazaki ◽  
Miyako Taira ◽  
Tomiteru Togano ◽  
Manabu Ohsaka ◽  
Yuhko Suzuki ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Myelodysplastic Syndrome ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Inverse Correlation ◽  
Consensus Method ◽  
Thrombocytopenic Purpura ◽  
Distribution Width ◽  
Platelet Counts ◽  
Reticulated Platelets ◽  
Immature Platelet Fraction

Abstract It is sometimes confusing to distinguish idiopathic thrombocytopenic purpura (ITP) from thrombocytopenia due to dysmegakaryopoiesis, as seen in myelodysplastic syndrome (MDS) patients, especially MDS with isolated thrombocytopenia. In this study, we investigated the useful parameters for the different diagnosis of thrombocytopenia. The number of reticulated platelets reflects the rate of thrombopoiesis, and this clinical utility has been established in the laboratory diagnosis of thrombocytopenia due to increased peripheral platelet destruction, such as autoimmune thrombocytopenic purpura (AITP). However, the number of reticulated platelets has not been well investigated in the patients with myelodysplatsic syndrome (MDS), while some of them are misdiagnosed as ITP. The aim of this study is to evaluate the diagnostic utility of the measurements of reticulated platelets as well as other parameters of platelets, such as MPV (mean platelet volume), P-LCR (platelet larger cell ratio) and PDW (platelet distribution width). The reticulated platelets, expressed as the immature platelet fraction (IPF) were determined in 108 ITP and 57 MDS patients using the Sysmex XE-2100 blood cell counter with upgraded software (Sysmex, Kobe, Japan). This system enabled rapid, inexpensive, automated, stable measurements of reticulated platelets compared with the flow cytometry system, of which consensus method has not yet been identified to provide acceptable intra- and inter-laboratory results. The platelet counts in ITP and MDS patients were equivalent (ITP, 7.99 ± 0.40 × 104/μL; MDS, 8.05 ± 0.57× 104/μL). The IPF values in ITP patients (10.4 ± 0.61%) were significantly higher than those in MDS (5.82 ± 0.63%), and the inverse correlation between the IPF and the platelet counts was observed among the ITP patients, but not among the MDS. Both MPV and PDW in MDS (10.6 +/− 0.15 fL and 12.2+/−0.41 fL, respectively) were significantly higher than in ITP (7.7 +/− 0.38 fL and 9.4 +/− 0.48 fL, respectively), while P-LCR in MDS (28.7 +/− 1.2%) and ITP (23.6 +/− 1.3%) were not significantly different. Although MPV was correlated with IPF among either group, the correlation between IPF and either PDW or P-LCR was weak among MDS (IPF × PDW, r=0.673; IPF × P-LCR, r=0.660) compared with ITP (IPF × PDW, r=0.779; IPF × P-LCR, r=0.803). Next we precisely investigated the clinical features of the minor population of MDS with higher IPF. Most of these patients revealed the significantly higher values of PAIgG (Platelet-associated IgG) and/or poor response to the blood transfusion, suggesting the possibility of associated autoimmune mechanisms. The patients of MDS in overt leukemic stage also recorded higher IPF even if they had no or few blood transfusion. The IPF would be a useful parameter to distinguish ITP from MDS with isolated thrombocytopenia, which has been shown to have a favorable prognosis.

Myelodysplastic Syndrome Mimicking Idiopathic Thrombocytopenic Purpura

2010 ◽  
Vol 30 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Yusun Hwang ◽  
Jung-Won Huh ◽  
Yeung-Chul Mun ◽  
Chu-Myong Seong ◽  
Wha Soon Chung
Keyword(s):  
Myelodysplastic Syndrome ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Thrombocytopenic Purpura

Idiopathic thrombocytopenic purpura in a cat

1999 ◽  
Vol 35 (6) ◽  
pp. 464-470 ◽  
Author(s):  
CL Garon ◽  
MA Scott ◽  
KA Selting ◽  
LA Cohn
Keyword(s):  
Bone Marrow ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Peripheral Blood ◽  
Core Biopsy ◽  
Response To Therapy ◽  
Initial Presentation ◽  
Thrombocytopenic Purpura ◽  
Immune Mediated ◽  
Cyclosporine Therapy

An 11-year-old, castrated, male domestic shorthair cat was presented for hematuria and pollakiuria. The cat had a marked thrombocytopenia, and a bone-marrow core biopsy demonstrated megakaryocytic hyperplasia with many megakaryocyte-associated neutrophils (i.e., emperipolesis). On peripheral blood, collected at initial presentation, what appeared to be platelets were noted to be within or adherent to occasional neutrophils. The thrombocytopenia was idiopathic in that no definitive cause could be found. However, platelet concentrations appeared to increase and decrease in response to changes in prednisone and cyclosporine therapy, suggesting a possible immune-mediated pathogenesis. As tests to detect increased feline platelet-associated antibodies are unavailable, immune-mediated thrombocytopenia can only be tentatively diagnosed in cats by exclusion and response to therapy.

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