Khor Zhong Xhen, Liam Christopher Chin Keong
Internal Medicine, Hospital Segamat, Segamat, MYS.
Hematology, Hospital Sultanah Aminah, Johor Bahru, MYS.
Cureus. 2024 Feb 28;16(2):e55174. doi: 10.7759/cureus.55174. eCollection 2024 Feb.
Inherited thrombocytopenia is a rare phenomenon. MYH9-related disorder (MYH9-RD) is one such pathology characterized by thrombocytopenia and giant platelets with the presence of cytoplasmic inclusion bodies in the granulocytes. The condition is often misdiagnosed as immune thrombocytopenia (ITP) due to its similarities in clinical phenotype and often no associated secondary causes. Ensuing treatments, frequently unnecessary, may predispose to adverse outcomes or perceived a lack of improvement. We report a young lady in her 20s who was eventually found to have MYH9-RD after her second pregnancy. A strong family history of thrombocytopenia, revision of her blood film (presence of giant platelets with no obvious platelet clumping, and the presence of Dohle body-like inclusions in the neutrophils), a lack of response to corticosteroids (treatment for ITP) eventually pointed us to this diagnosis. This case report aims to educate physicians regarding MYH9-RD as a rare but important entity when approaching chronic thrombocytopenia.
遗传性血小板减少症是一种罕见现象。MYH9相关疾病(MYH9-RD)就是这样一种病理状况,其特征为血小板减少和巨大血小板,同时粒细胞中存在胞质包涵体。由于其临床表型相似且通常无相关继发原因,该病症常被误诊为免疫性血小板减少症(ITP)。随之而来的治疗往往是不必要的,可能会导致不良后果或被认为治疗效果不佳。我们报告一名20多岁的年轻女性,她在第二次怀孕后最终被诊断为MYH9-RD。血小板减少症的家族病史强烈,复查她的血涂片(存在巨大血小板且无明显血小板聚集,中性粒细胞中存在类似杜勒小体的包涵体),对皮质类固醇(用于治疗ITP)无反应,最终使我们得出了这一诊断。本病例报告旨在让医生了解MYH9-RD作为一种罕见但重要的疾病,在处理慢性血小板减少症时的情况。