Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient
Background. Extramedullary hematopoiesis (EMH) is one of the rare causes of spinal cord compression (SCC). It results from noncancerous proliferation of hematopoietic tissue outside the bone marrow as a compensatory mechanism for ineffective erythropoiesis. It occurs in the paraspinal area in 11–15%...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/5827626 |
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| author | Ismail Ibrahim Ismail Fathi Massoud K. J. Alexander Jasem Youssef Al-Hashel |
| author_facet | Ismail Ibrahim Ismail Fathi Massoud K. J. Alexander Jasem Youssef Al-Hashel |
| author_sort | Ismail Ibrahim Ismail |
| collection | DOAJ |
| description | Background. Extramedullary hematopoiesis (EMH) is one of the rare causes of spinal cord compression (SCC). It results from noncancerous proliferation of hematopoietic tissue outside the bone marrow as a compensatory mechanism for ineffective erythropoiesis. It occurs in the paraspinal area in 11–15% of thalassemic patients in intermediate and severe cases causing a paraspinal compressive mass. We present a rare case of spinal EMH with thoracic cord compression in a 22-year-old female with beta thalassemia who presented with paraparesis and we provide a review of literature. Case Report. A 22-year-old female patient with a known history of beta thalassemia presented with subacute onset of weakness and numbness of both lower limbs with a sensory level at T6. Magnetic resonance imaging (MRI) of the dorsal spine showed cord compression secondary to paraspinal EMH from T2 to T9 with most prominent compression over T5. She was managed with blood transfusion and low-dose radiotherapy. Conclusion. Although rare, EMH should be suspected in thalassemic patients presenting with paraplegia. Treatment with blood transfusions is usually effective. Other options include radiotherapy, surgery, hydroxyurea or a combination of these modalities. |
| format | Article |
| id | doaj-art-0c55fc77740a471684a799d90eb76cde |
| institution | OA Journals |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-0c55fc77740a471684a799d90eb76cde2025-08-20T02:02:55ZengWileyCase Reports in Neurological Medicine2090-66682090-66762019-01-01201910.1155/2019/58276265827626Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic PatientIsmail Ibrahim Ismail0Fathi Massoud1K. J. Alexander2Jasem Youssef Al-Hashel3Department of Neurology, Ibn Sina Hospital, KuwaitDepartment of Neurology, Ibn Sina Hospital, KuwaitDepartment of Neurology, Ibn Sina Hospital, KuwaitDepartment of Neurology, Ibn Sina Hospital, KuwaitBackground. Extramedullary hematopoiesis (EMH) is one of the rare causes of spinal cord compression (SCC). It results from noncancerous proliferation of hematopoietic tissue outside the bone marrow as a compensatory mechanism for ineffective erythropoiesis. It occurs in the paraspinal area in 11–15% of thalassemic patients in intermediate and severe cases causing a paraspinal compressive mass. We present a rare case of spinal EMH with thoracic cord compression in a 22-year-old female with beta thalassemia who presented with paraparesis and we provide a review of literature. Case Report. A 22-year-old female patient with a known history of beta thalassemia presented with subacute onset of weakness and numbness of both lower limbs with a sensory level at T6. Magnetic resonance imaging (MRI) of the dorsal spine showed cord compression secondary to paraspinal EMH from T2 to T9 with most prominent compression over T5. She was managed with blood transfusion and low-dose radiotherapy. Conclusion. Although rare, EMH should be suspected in thalassemic patients presenting with paraplegia. Treatment with blood transfusions is usually effective. Other options include radiotherapy, surgery, hydroxyurea or a combination of these modalities.http://dx.doi.org/10.1155/2019/5827626 |
| spellingShingle | Ismail Ibrahim Ismail Fathi Massoud K. J. Alexander Jasem Youssef Al-Hashel Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient Case Reports in Neurological Medicine |
| title | Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient |
| title_full | Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient |
| title_fullStr | Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient |
| title_full_unstemmed | Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient |
| title_short | Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient |
| title_sort | compressive dorsal myelopathy secondary to extramedullary hematopoiesis in a thalassemic patient |
| url | http://dx.doi.org/10.1155/2019/5827626 |
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