title: Excessive naked megakaryocyte nuclei in myelodysplastic syndrome mimicking idiopathic thrombocytopenic purpura: a complicated pre- and post-transplantation course.
abstract: A boy 3 years 7 months old with thrombocytopenia and history of intracranial hemorrhage who underwent bone marrow transplantation is presented. He was refractory to steroids, immunoglobulin G, vincristine, azathioprine, cyclosporine A, interleukin-11, chemotherapy, and splenectomy. Idiopathic thrombocytopenic purpura was excluded by light /electron microscopic and flow cytometric findings; the diagnosis of refractory cytopenia, a subgroup of pediatric myelodysplastic syndrome, was made. Naked megakaryocyte nuclei were 55.38 +/- 28.2% vs. 31.67 +/- 23.22% of all megakaryocytes in the patient and the control group of 9 patients with idiopathic thrombocytopenic purpura, respectively (p = .016). The posttransplatation course was complicated by delayed platelet engraftment, bronchiolitis obliterans associated with pneumocystis carinii pneumonia, which resolved completely.
authors: Dr A.Y. Ankara Oncology Research and Education Hospital, Unit of Pediatric Hematology, Demetevler, Ankara, Turkey. laleolcay@hotmail.com.tr
authors: Lale
authors: L
authors: Olcay
authors: A Murat
authors: AM
authors: Tuncer
authors: Hamza
authors: H
authors: Okur
authors: Esra
authors: E
authors: Erdemli
authors: Zumrut
authors: Z
authors: Uysal
authors: Mualla
authors: M
authors: Cetin
authors: Feride
authors: F
authors: Duru
authors: Duygu Uckan
authors: DU
authors: Cetinkaya
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016022:Case-Control Studies; D002467:Cell Nucleus / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007223:Infant; D008297:Male; D008533:Megakaryocytes / Q000473:pathology*; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000628:therapy; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis* / Q000628:therapy