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• W2912708430 abstract "Absztrakt: Mersekelt thrombocytosis szamos korkephez tarsulhat (verzes, gyulladas, vashiany, autoimmun betegsegek stb.), de tartos, 450 G/l folotti verlemezkeszam eseten a beteg hematologiai kivizsgalasa javasolt, ha a thrombocytosist egyeb, gyakoribb ok nem magyarazza. Egy 47 eves nő anamneziseben hypertonia, asthma bronchiale, endometriosis szerepel. Kivizsgalasa 2015 marciusaban fogyas, etvagytalansag miatt indult. Laboratoriumi vizsgalatai kozul kiemelhető az emelkedett thrombocytaszam (617 G/l), vashianya nem volt. 2015. aprilis 7-en jelentkezett bal bordaiv alatti akut fajdalom miatt, amelynek hattereben egyszerű kepalkoto vizsgalatok elterest nem mutattak. A hasi CT-vizsgalat az aorta abdominalis szakaszan 4,5 cm-es thrombust irt le, amely beterjedt a bal arteria renalisba, es elzarta azt. Az APTI-hez (aktivalt parcialis thromboplastinidő) igazitott folyamatos natrium-heparin kezelest inditottunk. A kesőbb megerkezett JAK2V617F-mutacio-analizis pozitiv lett, majd a csontvelővizsgalat korai/praefibroticus myelofibrosist igazolt, igy hidroxiureakezelest is kezdtunk. Az alkalmazott kezelesek hatasara a beteg panaszai megszűntek, thrombocytaszama fokozatosan normalizalodott. Bar a mersekelt thrombocytosis gyakran masodlagos jelenseg, ha tartosan fennall, es főkent ha thromboembolias esemenyek is kiserik, verkepző rendszeri betegseg, elsősorban Philadelphia-kromoszoma-negativ kronikus myeloproliferativ korkep lehetősegere is gondolni kell. Klinikailag az essentialis thrombocythaemia es a primer myelofibrosis korai, praefibroticus fazisa nagyon hasonlo lehet, igy a differencialdiagnozis csak a csontvelő szovettani vizsgalataval lehetseges, mely az elterő prognozis es kezelesi lehetősegek miatt elengedhetetlenul szukseges. Orv Hetil. 2018; 159(15): 603–609. | Abstract: Moderate thrombocytosis can accompany several diseases (bleeding, inflammation, iron deficiency, or autoimmune diseases), but hematologic examination is strongly recommended in a patient with persistent platelet count above 450 G/L unless reactive origin can be confirmed. The 47-year-old woman’s medical history included hypertonia, asthma bronchiale, and endometriosis. In March 2015, she underwent laboratory examination due to weight loss and lack of appetite. Her results showed elevated thrombocyte count (617 G/L), but no iron deficiency. She presented in our clinic on 07. 04. 2015 with acute pain below her left hypochondrial region, but simple imaging examinations showed no difference to explain it. Abdominal CT revealed a 4.5 cm thrombus which protruded into the left renal artery, blocking it. We started APTI- (activated partial thromboplastin time) monitored continuous intravenous treatment with unfractionated heparin. The JAK2V617F mutation analysis came back positive. Subsequent bone marrow examination revealed prefibrotic/early stage myelofibrosis, prompting treatment with hydroxyurea. The applied treatments led to the disappearance of the patient’s symptoms accompanied by the gradual normalisation of the thrombocyte count. Moderate thrombocytosis is often secondary, but if it persists and is accompanied by mainly thromboembolic events, the risk of diseases of the haematopoietic system, primarily Philadelphia chromosome negative chronic myeloproliferative disease should also be considered. Clinically, essential thrombocythaemia and the prefibrotic/early stage of myelofibrosis can be very similar. Differential diagnosis is only possible through the histological examination of the bone marrow, which becomes indispensible due to the difference in prognosis and treatment options. Orv Hetil. 2018; 159(15): 603–609." @default.
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• W2912708430 date "2018-01-01" @default.
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• W2912708430 title "A korai/praefibroticus primer myelofibrosis kivizsgálása és kezelése egy eset kapcsán = Investigation and treatment of prefibrotic/early primary myelofibrosis. A case study" @default.
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