Incomplete paraplegia caused by extramedullary hematopoiesis in a patient with thalassemia intermedia

Spinal Cord Series and Cases
Nurhasyimah Hisamud-DinNatiara Mohamad Hashim

Abstract

Extramedullary hematopoiesis (EMH) is the production of blood cell precursors outside the bone marrow that occur in various hematological diseases. In patients with thalassemia intermedia, ineffective erythropoiesis drives compensatory EMH in the liver, pancreas, pleura, spleen, ribs and spine. We describe a patient with thalassemia intermedia who presented with acute neurological symptoms caused by paraspinal EMH, which responded well to combination therapy of steroid, hypertransfusion, laminectomy and excision of pseudotumor and hydroxyurea therapy to boost the formation of fetal haemoglobin. Prompt recognition of EMH based on clinical presentation and typical radiological findings should be made. Early treatment is recommended to prevent irreversible damage to the spinal cord.

References

Aug 1, 1983·Journal of Neurology, Neurosurgery, and Psychiatry·A W IbrahimA Kuppa
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Mar 6, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Rachid HaidarAli T Taher
Apr 23, 2011·World Journal of Radiology·Paolo SaviniGiuseppe Francesco Stefanini

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Citations

Sep 5, 2020·Clinical Case Reports·Lobna Ben AmmarWafa Hamdi

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