Edahiro Yoko, Ando Jun, Suzuki Toshifumi, Fukumura Yuki, Masuda Azuchi, Sakayori Shiori, Takeda Jun, Maruyama Yojiro, Makino Shintaro, Itakura Atsuo, Komatsu Norio
Department of Hematology, Juntendo University School of Medicine, Japan.
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Japan.
Intern Med. 2018 Dec 15;57(24):3647-3650. doi: 10.2169/internalmedicine.1311-18. Epub 2018 Aug 10.
Myeloproliferative neoplasms (MPNs), including polycythemia vera, essential thrombocythemia (ET), and primary myelofibrosis, mainly occur in older patients, but have also been reported in younger patients. A "second peak" occurs in female patients in their thirties, particularly in ET; thus, the management of pregnancy is often discussed. We herein present the case of a 33-year-old woman with a high platelet count and multiple placental infarcts during delivery who was subsequently diagnosed with ET. Although there are no worldwide guidelines for the management of MPNs in pregnancy, the risk of thrombosis is markedly increased in these patients, and antithrombotic therapy should be considered.
骨髓增殖性肿瘤(MPNs),包括真性红细胞增多症、原发性血小板增多症(ET)和原发性骨髓纤维化,主要发生于老年患者,但也有在年轻患者中报道的情况。在三十多岁的女性患者中出现一个“第二高峰”,尤其是在ET中;因此,妊娠管理问题经常被讨论。我们在此报告一例33岁女性病例,该患者分娩时血小板计数高且有多处胎盘梗死,随后被诊断为ET。尽管目前尚无关于妊娠合并MPNs管理的全球指南,但这些患者血栓形成风险显著增加,应考虑进行抗血栓治疗。