 |
Case Report
Concomitant megaloblastic anemia and myelodysplastic syndrome
1 Graduate Student, Department of Community Health And Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
2 Physician, Clinical Associate Professor, Department of Internal Medicine, University of Saskatchewan/Saskatchewan Health Authority, Prince Albert, Saskatchewan, Canada
3 Professor, Department of Pathology, University of Saskatchewan/ Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
Address correspondence to:
Anurag Saxena
MBBS, MD, M.Ed., MBA, FRCPC, FCAP, CHE, CCPE, Associate Dean, Postgraduate Medical Education, Room 402, St. Andrew’s College, 1121 College Drive, Saskatoon, SK, S7N 0W3,
Canada
Message to Corresponding Author
Article ID: 100026Z11AK2018
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Khan A, Bensaleh A, Saxena A. Concomitant megaloblastic anemia and myelodysplastic syndrome. J Case Rep Images Pathol 2018;4:100026Z11AK2018.ABSTRACT
Introduction: Megaloblastic Anemia (MBA) and Myelodysplastic Syndrome (MDS) are broadly regarded as mutually exclusive entities in the diagnostic workup of macrocytic anemia. MBA is a reversible form of ineffective hematopoiesis and MDS is an irreversible disorder of ineffective hematopoiesis manifested in part by karyotype anomalies due to DNA damage characterized by stem cell dysfunction. However, there is significant overlap in their clinical presentation and in investigatory parameters.
Case Report: A 67-year-old man initially presented with insidious onset fatigue and during diagnostic workup was found to have marked pancytopenia, macrocytic anemia, a megaloblastic peripheral blood picture and reduced serum Vitamin B12 establishing the diagnosis of MBA. Replacement therapy resulted in moderate improvement. Persistence of pancytopenia led to a bone marrow examination. The combination of a hypercellular marrow with significant erythroid dysplasia and a clonal abnormality-t (9;11)(p22;q23) led to a diagnosis of myelodysplastic syndrome–unclassified (MDS-U).
Conclusion: This case suggests that MBA & MDS can occur simultaneously and clinicians should take into account concomitant existence during the workup, when pancytopenia persists after treatment or there are other features suspicious for MDS.
Keywords: Megaloblastic Anemia, Myelodysplastic Syndrome, Pancytopenia
SUPPORTING INFORMATION
Author Contributions
Amal Khan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Adel Bensaleh - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Final approval of the version to be published
Anurag Saxena - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Amal Khan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
