Essential Thrombocythemia in a Two-year-old Child, Responsive to Hydroxyurea but Not Aspirin

Abstract

Essential thrombocythemia (ET) is a myeloproliferative neoplasm that occurs mostly in patients above the age of 50 years. Its incidence in children is very rare, with around 100 cases reported in the literature. High-risk patients are defined by previous life threatening major thrombotic or severe hemorrhagic complication or age > 60. Those patients probably benefit from cytoreductive therapy. On the other hand, antiplatelet drugs are recommended for patients with low risk group. Although rare, ET should be considered in the differential diagnosis of persistent thrombocytosis in children, even at a very young age. A constellation of clinical, pathologic, and molecular testing are essential for diagnosis. Given the rarity of these cases, there is currently no consensus for treatment guidelines in children, especially in asymptomatic patients. We describe a case of a two-year old girl who presented with unexplained, isolated thrombocytosis which persisted for eight years. Bone marrow biopsy demonstrated typical features of ET. Over the course of the disease, hydroxyurea, but not aspirin, showed better control of symptoms and lowered the platelets level.

Incidence, Risk Factors and Prognosis of Acute Kidney Injury Following Hematopoietic Stem Cell Transplant: A Pilot Study

“…The results of this present study suggest that AKI is an early complication that commonly happens in the first 90 days and may have a negative effect on prognosis. The overall incidence of AKI during the 3-month follow-up was 31.6%, which is lower than the rates reported in previous research (12, 14). The KDIGO Clinical Practice Guideline for Acute Kidney Injury introduced the RIFLE criteria-Risk, Injury, and Failure; and the two outcome classes: Loss and End-Stage Renal Disease (ESRD) to define AKI and the severity classes (13).…”

“…In Jordan, descriptive studies and case reports of HSCT in the pediatric population with immunodeficiency disease and malignancies have been conducted. However, more emphasis on HSCT-related morbidity and mortality in adults is warranted (4, 5).…”

“…The related-HSCT medication has a toxic effect and produces early and late complications such as acute kidney injury (AKI) despite the type of HSCT. AKI is one of the early medical conditions that could be caused by hemodynamic instability, toxicities of the administered medications and/or conditioning therapy before and after HSCT (5). Adjustment of the chemotherapy dose, reliable facility services and highly trained personnel have begun to show promising indicators of safety in HSCT therapy (8).…”

“…However, this classification was not applied prospectively to adult patients who underwent HSCT therapy. The vast majority of studies evaluated AKI in pediatric patients who received the HSCT procedure (13, 14). RIFLE was developed to classify acute renal failure (ARF) defined in three grades of severity–Risk (R), Injury (I) and Failure (F).…”

Trombositoz saptanan çocuklarda klinik ve hematolojik profilin değerlendirilmesi

“…. Literatürde esansiyel trombositoz insidansı 100000'de 0,6-2,5 olarak bildirilmiştir [5]. Onbir bin altıyüz kırk üç (11643) trombositoz saptanan hastanın tarandığı çalışmamızda esansiyel trombositoz görülmedi.…”