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中间型地中海贫血合并慢性髓性白血病患者的神经并发症:一例髓外造血引起的脊髓压迫症

Neurological Complications in a Patient With Thalassemia Intermedia and Chronic Myeloid Leukemia: A Case of Extramedullary Hematopoiesis-Induced Spinal Cord Compression.

作者信息

Onder Ozlem, Isik Sahin, Ceylan Ersen

机构信息

Department of Neurology, Near East University, Nicosia, CYP.

Department of Radiation Oncology, Near East University, Nicosia, CYP.

出版信息

Cureus. 2025 May 26;17(5):e84844. doi: 10.7759/cureus.84844. eCollection 2025 May.

Abstract

Extramedullary hematopoiesis (EMH) is a rare but significant compensatory response to chronic ineffective erythropoiesis, frequently seen in hematologic disorders such as thalassemia intermedia (TI) and chronic myeloid leukemia (CML). While EMH is typically asymptomatic, it can manifest as paraspinal masses that cause spinal cord compression, resulting in severe neurological deficits. This case highlights the complexities in managing overlapping hematologic conditions and emphasizes the importance of timely diagnosis and intervention. We present a 50-year-old male with a longstanding history of TI and CML, who developed progressive lower extremity weakness, gait instability, and sensory deficits due to spinal cord compression from EMH. This case underscores the critical need for clinical awareness and early intervention in patients with hematologic disorders who present with neurological symptoms. EMH-induced spinal cord compression, though rare, can lead to significant morbidity if left untreated. Multidisciplinary management involving neurology, hematology, radiology, and rehabilitation is essential to optimize outcomes and prevent permanent neurological deficits in affected patients.

摘要

髓外造血(EMH)是对慢性无效红细胞生成的一种罕见但重要的代偿性反应,常见于中间型地中海贫血(TI)和慢性粒细胞白血病(CML)等血液系统疾病。虽然EMH通常无症状,但可表现为引起脊髓压迫的椎旁肿块,导致严重的神经功能缺损。本病例突出了处理重叠血液系统疾病的复杂性,并强调了及时诊断和干预的重要性。我们报告一名50岁男性,有长期TI和CML病史,因EMH导致脊髓压迫而出现进行性下肢无力、步态不稳和感觉缺损。本病例强调了对出现神经症状的血液系统疾病患者进行临床警惕和早期干预的迫切需求。EMH引起的脊髓压迫虽然罕见,但如果不治疗可导致严重的发病率。涉及神经科、血液科、放射科和康复科的多学科管理对于优化结局和预防受影响患者的永久性神经功能缺损至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75f2/12191413/e3c5a7c3eea8/cureus-0017-00000084844-i01.jpg

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