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Medical Oncology

, Volume 15, Issue 4, pp 275–278 | Cite as

Platelet dysfunction as the presenting feature of atypical myelodysplastic syndrome with monosomy 7, normal blood counts and no bleeding tendency

  • Dragomir Marisavljević
  • Peter Antunović
  • Predrag Miljić
  • Milena Pantić
Paper

Abstract

A 71-year-old male patient with atypical myelodysplastic syndrome showing monosomy 7 is described. He presented with severe foot pains, trophic skin and nail changes, loss of distal pulses, all compatible with peripheral arterial occlusive disease. He had completely normal blood counts and no bleeding tendency. Prolonged bleeding time was disclosed by chance, during routine haemostatic studies. An acquired platelet dysfunction was considered, with prolonged bleeding time and large platelets that failed to aggregate in response to arachidonic acid and that had impaired response to collagen and adrenaline. The bone marrow was hypercellular, with numerous dysplastic megakaryocytes and two other slightly dysplastic myeloid lines. Cytogenetic analyses of the bone marrow cells showed a mosaic karyotype: 46,XY/45,XY,-7. On angiography, bilateral thrombosis of the iliac, superficial femoral and popliteal arteries was disclosed. The patient was prepared with platelet transfusions. Arterial thrombectomy and amputation of the left calf were performed. Ten months later, his blood counts showed mild pancytopenia. He died at home. The authors discuss some clinical and pathogenetical aspects of such presentations of myelodysplastic syndromes.

Keywords

myelodysplastic syndromes platelet dysfunction normal blood counts monosomy 7 

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Copyright information

© Stockton Press 1998

Authors and Affiliations

  • Dragomir Marisavljević
    • 1
  • Peter Antunović
    • 1
  • Predrag Miljić
    • 1
  • Milena Pantić
    • 1
  1. 1.Clinical Centre of SerbiaInstitute of HaematologyBelgradeYugoslavia

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