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  • Author: Supat Chamnanchanunt x
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Pravinwan Thungthong, Supat Chamnanchanunt, Tawatchai Suwanban, Chajchawan Nakhakes and Kunapa Iam-arunthai

Abstract

Background

A Janus kinase 2 (JAK2) mutation polycythemia vera (PV) is a common manifestation of stem cell disorder. However, available data on the clinical and treatment response of JAK2-negative PV patients are limited.

Objectives

We report the case and clinical course of a patient with PV and left hemiparesis who was JAK2V617-negative.

Methods

We conducted a literature review and compared our patient with previously published reports of JAK2-negative patients with P V.

Results

Our patient presented with hemiparesis without a previous history of hematological disease. He was diagnosed with PV based on the British Committee for Standards in Haematology guidelines 2007. He underwent only phlebotomy with subsequent improvement of his neurological condition. He was discharged with therapeutic phlebotomy for one and a half months.

Conclusions

Although this rare condition required complex diagnostic criteria, the patient achieved good clinical outcome with therapeutic phlebotomy alone.

Open access

Supat Chamnanchanunt, Pravinwan Thungthong, Sirvicha Kudsood, Waraporn Somwong and Manassamon Hirunmassuwan

Abstract

Background

Anemia is a common problem among patients with malaria infection, which induces hemolysis during treatment. A few patients present with autoimmune hemolytic anemia (AIHA) and autoantibodies, such as autoanti-E and autoanti-I, during malaria infection.

Objective

To report the clinical response of a patient with Plasmodium falciparum malaria infection with a hemolytic condition.

Methods

We reviewed medical records of a patient with P. falciparum malaria and related literature.

Results

Our patient presented with P. falciparum malaria infection and received artesunate and ceftriaxone to cover potential tropical infectious diseases. After malaria parasite was eradicated, her hemoglobin declined, and AIHA and autoantibodies were found, explaining the cause of anemia. Corticosteroid was given at a standard dosage, and her hemoglobin became normal within 1 week.

Conclusion

Patients with falciparum malaria and both AIHA and autoantibody complications are rare. Our patient responded to malaria eradication and corticosteroid treatment. Most cases reported seem to respond to corticosteroid with a variety of recovery times. However, corticosteroids might increase the severity of infection; more clinical data to support a standard regimen to treat properly rare hematologic complications (AIHA and autoantibodies) in malaria patients are warranted.

Open access

Supat Chamnanchanunt, Chajchawan Nakhakes, Pravinwan Thungthong, Tawatchai Suwanban, Kunapa Iam-arunthai, Napat Sukgasi and Maleerat Sutherat

Abstract

Background: Primary granulocytic sarcoma (GS) only rarely presents with an ovarian mass classified as extramedullary myeloid progenitor tumor cells. Few patients with cases of primary GS survive after systemic chemotherapy.

Objective: To present a case of primary GS treated with complete course of chemotherapy. The patient is currently in complete remission.

Methods: Retrospective review of medical records and comparison with previous case reports.

Results: A 41-year-old woman presented with an ovarian mass of 6 months duration. There was no previous history of hematologic disease or presence of leukemic cells in other organs at the time of diagnosis. Immunohistochemistry confirmed the diagnosis. She received complete course of chemotherapy, after which complete remission was achieved.

Conclusion: A case of primary granulocytic sarcoma of the ovary was successfully treated with chemotherapy. This disease needs careful diagnosis and appropriate treatment for a good outcome.

Open access

Supat Chamnanchanunt, Pravinwan Thungthong, Niphon Praditphol, Kunapa Iam-arunthai, Jirapong Dowreang, Chajchawan Nakhakes and Tawatchai Suwanban

Abstract

Background

Polycythemia vera has been found in a wide range of hematopoietic tissue disorders, but rarely concomitant with renal abnormality. To our knowledge there is only one available report of a patient with polycythemia vera concomitant with renal angiomyolipoma, and the report does not cover the clinical course of this rare finding.

Objectives

To report the presentation and clinical course of a patient with polycythemia vera concomitant with right renal angiomyolipoma.

Methods

We retrospectively reviewed the medical records of a patient with polycythemia vera who presented with renal angiomyolipoma.

Results

Our patient presented with a right renal mass and polycythemia vera diagnosed by a point mutation in the gene for Janus kinase 2. The mass was diagnosed as renal angiomyolipoma on histopathology. After partial nephrectomy, she was prescribed a low dosage of hydroxyurea without the return of erythrocytosis for a year.

Conclusions

Polycythemia vera responded well to low dosage hydroxyurea, which controlled erythrocytosis after removing the renal mass.