tailieunhanh - báo cáo khoa học: "Spontaneous splenic rupture in Waldenstrom’s macroglobulinemia: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Spontaneous splenic rupture in Waldenstrom’s macroglobulinemia: a case report | Charakidis and Russell Journal of Medical Case Reports 2010 4 300 http content 4 1 300 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Spontaneous splenic rupture in Waldenstrom s macroglobulinemia a case report Michail Charakidis David Joseph Russell Abstract Introduction We report the case of a patient with Waldenstrom s macroglobulinemia complicated by spontaneous splenic rupture. Case presentation A 49-year-old Caucasian woman was referred to our emergency department by her general practitioner following a three-week history of malaise night sweats six kilograms of weight loss intermittent nausea and vomiting progressive upper abdominal pain and easy bruising. On the fourth day following her admission she had a rapid clinical deterioration with subsequent radiological investigations revealing a splenic rupture. Her morphology biochemistry flow cytometry and histology were strongly suggestive of Waldenstrom s macroglobulinemia. Conclusions Spontaneous splenic rupture is not an expected complication of low-grade lymphoplasmacytic lymphomas such as Waldenstrom s macroglobulinemia. To the best of our knowledge this is the only reported case of early spontaneous splenic rupture due to Waldenstrom s macroglobulinemia. Our case highlights that despite the typical disease course of low-grade hematological malignancies signs and symptoms of imminent splenic rupture should be considered when formulating a clinical assessment. Introduction According to current World Health Organization WHO consensus Waldenstrom s macroglobulinemia WM is defined as a lymphoplasmacytic lymphoma LPL with bone marrow involvement and an IgM of any concentration 1 2 . Although a familial component has been identified in up to 20 percent of patients WM is generally considered a sporadic disease 1 2 . The most important risk factor is IgM monoclonal gammo-pathy of undetermined significance MGUS . Another implicated epidemiological factor in the .