A Case of Myelodysplastic Syndrome Characterized by Hemolytic Anemia at Presentation.
- Author:
Yu Kyung KIM
1
Author Information
- Publication Type:Case Report
- Keywords: Hemolytic anemia; Myelodysplastic syndrome; Refractory cytopenia with multilineage dysplasia
- MeSH: Anemia, Hemolytic*; Antibodies; Bilirubin; Bone Marrow; Bone Marrow Cells; Chromosome Aberrations; Coombs Test; Drug Therapy; Dyspnea; Erythrocytes; Haptoglobins; Hemoglobinuria, Paroxysmal; Karyotype; L-Lactate Dehydrogenase; Leukocyte Count; Myelodysplastic Syndromes*; Neutrophils; Platelet Count; Reticulocyte Count
- From:Laboratory Medicine Online 2016;6(1):41-44
- CountryRepublic of Korea
- Language:Korean
- Abstract: A man aged 78 yr with no history of chemotherapy or toxic exposure presented with a history of dyspnea and intermittent red urine for 3 months and several years, respectively. Hematologic data at admission were as follows: hemoglobin, 65 g/L; white blood cell count, 4.05x109/L; platelet count, 96x109/L; and reticulocyte count, 10.9%. A peripheral blood smear revealed polychromasia, nucleated red blood cells, and neutrophils with a non-lobulated nucleus. The bone marrow was hypercellular and exhibited an increase in erythroid precursors with trilineage dysplasia and our findings were suggestive of refractory cytopenia with multilineage dysplasia (RCMD). Karyotype of bone marrow cells was as follows: 45,XY,der(9;17)(p10;q10),add(18)(q11.2)[10]/45,idem,del(3)(q21)[10]. Other laboratory findings showed decreased serum haptoglobin, increased lactate dehydrogenase, and increased indirect bilirubin levels. Moreover, results of the direct/indirect antiglobulin test (Coombs' test) and paroxysmal nocturnal hemoglobinuria analysis with CD55, CD59, fluorescent aerolysin (FLAER), and CD24 were negative. Cold agglutinin and Donath-Landsteiner antibodies were not detected. This is a case of myelodysplastic syndrome (MDS) associated with hemolytic anemia and complex chromosomal abnormalities at presentation.
