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대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제30권 제2호
발행연도
2010.1
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105 - 110 (6page)

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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. (Korean J Lab Med 2010;30:105-10)
#Thrombocytopenia #ITP #MDS #Cytogenetics #WHO

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참고문헌 (9)

참고문헌 신청
Gupta R / 2007 / Myelodysplastic syndrome with isolated deletion of chromosome 20q: an indolent disease with minimal morphological dysplasia and frequent thrombocytopenic pre google schola Jaffe ES / 2001 / World Health Organization classification of tumours. Pathology and genetics of tumours of haematopoietic and lymphoid tissues / IARC Press : 61 ~ 74 google schola Kuroda J / 2002 / Unusual myelodysplastic syndrome with the initial presentation mimicking idiopathic thrombocytopenic purpura / Acta Haematol 108 : 139 ~ 143 google schola Menke DM / 1992 / Refractory thrombocytopenia. A myelodysplastic syndrome that may mimic immune thrombocytopenic purpura / Am J Clin Pathol 98 : 502 ~ 510 google schola Rodeghiero F / 2003 / Idiopathic thrombocytopenic purpura: an old disease revisited in the era of evidence-based medicine / Haematologica 88 : 1081 ~ 1087 google schola

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