title: Paraplegia due to extramedullary hematopoiesis in thalassemia treated successfully with radiation therapy.
abstract: Spinal cord compression due to extramedullary hematopoiesis (EMH) is a rare complication of thalassemia and generally presents as paraparesis with sensory impairment. Complete paraplegia is extremely rare in EMH due to thalassemia although it is known to occur in polycythemia vera and sickle cell anemia. Treatment options mostly include surgery and/or radiotherapy. Whereas cases presenting with paraparesis have been treated with either surgery or radiotherapy with equal frequency and efficacy, almost all reported cases with paraplegia have been treated with surgery with or without radiation therapy. We hereby report a case of thalassemia intermedia with paraplegia treated successfully with radiotherapy.
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India. dr_monica_malik@hotmail.com
authors.forename: Monica
authors.initials: M
authors.lastname: Malik
authors.forename: Lakshmi S
authors.initials: LS
authors.lastname: Pillai
authors.forename: Nidhi
authors.initials: N
authors.lastname: Gogia
authors.forename: Tarun
authors.initials: T
authors.lastname: Puri
authors.forename: M
authors.initials: M
authors.lastname: Mahapatra
authors.forename: Daya Nand
authors.initials: DN
authors.lastname: Sharma
authors.forename: Rajat
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D002118:Calcium / Q000627:therapeutic use; D003037:Cobalt Radioisotopes / Q000627:therapeutic use*; D000075202:Contraindications; D019299:Decompression, Surgical; D004164:Diphosphonates / Q000627:therapeutic use; D004824:Epidural Space; D005492:Folic Acid / Q000627:therapeutic use; D005598:Fractures, Spontaneous / Q000209:etiology; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy; D010264:Paraplegia / Q000209:etiology*; D011867:Radioisotope Teletherapy; D013117:Spinal Cord Compression / Q000150:complications / Q000532:radiotherapy*; D000077211:Zoledronic Acid; D017086:beta-Thalassemia / Q000150:complications* / Q000503:physiopathology / Q000628:therapy
chemical_list: D003037:Cobalt Radioisotopes; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D005492:Folic Acid; D002118:Calcium