J Med Life Sci > Volume 17(3); 2020 > Article
Journal of Medicine and Life Science 2020;17(3):103-106.
DOI: https://doi.org/10.22730/jmls.2020.17.3.103    Published online December 31, 2020.
Severe anemia caused by secondary myelofibrosis in a patient with angioimmunoblastic peripheral T-cell lymphoma
Jaemin Jo1, Jeong Ho Kang2
1Department of Internal medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
2Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
Correspondence:  Jeong Ho Kang, Tel: 82-64-717-1924, Fax: 82-64-717-1168,  Email: sivakjh1234@gmail.com
Received: 15 July 2020   • Revised: 28 July 2020   • Accepted: 6 August 2020
Abstract
Bone marrow failure, such as aplastic or myelophthisic anemia, can occur due to an underlying lymphoid malignancy and cause life-threatening events. A 58-year-old man diagnosed with angioimmunoblastic T-cell lymphoma had recently visited the emergency department because of an altered level of consciousness caused by acute severe anemia. The laboratory findings were strongly suggestive of bone marrow failure syndrome. Bone marrow examination was immediately performed and, subsequently, dexamethasone was initiated to control the underlying lymphoma. Intravenous immunoglobulin was also administered in combination due to combined immune hemolytic anemia and thrombocytopenia. Bone marrow examination revealed a packed marrow with marked fibrosis and lymphoma involvement. A diagnosis of secondary myelofibrosis related to the underlying lymphoma was made, and sequential combination chemotherapy was introduced despite the presence of severe anemia and thrombocytopenia. After combination chemotherapy, his hematologic profile and underlying lymphoma improved. Better understanding of various hematologic manifestations and knowledge of the rare condition of lymphoma are essential for appropriate diagnostic approaches and treatment.
Key Words: Bone marrow failure, Angioimmunoblastic T-cell lymphoma, Anemia, Diagnosis
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