Qualitative and quantitative platelet defect with bleeding symptoms as presenting feature of non Hodgkin lymphomas.
A young man with bleeding symptoms, mild thrombocytopenia and abundant marrow megakaryocytes was classified as having idiopathic thrombocytopenic purpura. Neither prednisone therapy nor splenectomy modified the clinical picture. Subsequently, a severe defect of platelet aggregation and release reaction was demonstrated. Fifteen months after the onset of bleeding symptoms, fever and hepatomegaly appeared and the diagnosis of T cell non Hodgkin lymphoma was made on the basis of a histologic review of paraffin sections of the spleen. Chemotherapy induced remission of the lymphoma, disappearance of bleeding symptoms and normalization of the platelet count and function.
Bertolino
G
G
Dipartimento di Medicina Interna, Clinica Medica II, IRCCS, Policlinico San Matteo, Pavia, Italy.
Noris
P
P
Balduini
C L
CL
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D001792:Blood Platelets / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003951:Diagnostic Errors; D004317:Doxorubicin / Q000008:administration & dosage; D004438:Ecchymosis / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D016399:Lymphoma, T-Cell / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008533:Megakaryocytes / Q000473:pathology; D008727:Methotrexate / Q000008:administration & dosage; D010979:Platelet Function Tests; D011241:Prednisone / Q000008:administration & dosage; D011693:Purpura / Q000175:diagnosis / Q000209:etiology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis; D013154:Spleen / Q000473:pathology; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000209:etiology; D014750:Vincristine / Q000008:administration & dosage
D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002955:Leucovorin; D011241:Prednisone; D008727:Methotrexate