Conte Guillermo, López Miguel, Alarcón Pablo
Sección Hematología Hospital Clínico, Universidad de Chile, Santiago, Chile.
Escuela de Postgrado, Facultad de Medicina, Universidad de Chile, Chile.
Rev Med Chil. 2018 Sep;146(9):1074-1078. doi: 10.4067/s0034-98872018000901074.
We report a 51-year-old female who had a first episode of thrombocytopenia at 23 years of age during a pregnancy. At the age of fifty, a hysterectomy was indicated due to a metrorrhagia: a platelet count of 21,000/ul was detected. She was treated with eltrombopag with a good response. The family history of the patient revealed the presence of thrombocytopenia in several family members. Suspecting a hereditary thrombocytopenia, a genetic study revealed a mutation in the MYH-9 gene. This mutation can be suspected when there is a family history of thrombocytopenia with autosomal dominant inheritance, macrothrombocytopenia and in this particular case, due to the response to thrombopoietin receptor agonist, eltrombopag.
我们报告了一名51岁女性,她在23岁怀孕时首次出现血小板减少症。五十岁时,因子宫出血而进行了子宫切除术,当时检测到血小板计数为21,000/微升。她接受了艾曲泊帕治疗,反应良好。患者的家族史显示几个家庭成员存在血小板减少症。怀疑是遗传性血小板减少症,基因研究发现MYH-9基因存在突变。当有血小板减少症的家族史且为常染色体显性遗传、存在大血小板减少症时,以及在这种特殊情况下,由于对血小板生成素受体激动剂艾曲泊帕有反应,就可能怀疑存在这种突变。