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A Febrile Patient with Polyarthritis, Visceromegaly and Cytopenias
Author(s):
1. Zia Ehsan Kakar: Akbar Niazi Teaching Hospital (ANTH), Islamabad, Pakistan
2. Rizwan Aziz Qazi: Akbar Niazi Teaching Hospital (ANTH), Islamabad, Pakistan
3. Aimal Khan: Akbar Niazi Teaching Hospital (ANTH), Islamabad, Pakistan
4. Numair Hafeez: Akbar Niazi Teaching Hospital (ANTH), Islamabad, Pakistan
Abstract:
A case of asymmetrical patient, and fewer of 6 months duration. Clinically also had hepatosplenomegaly. The lab investigation revealed Cytopenias with TLC of TLC 1830μl, Hb 9.5g/dl, platelets 44000mL, and high ESR that is 75. Patient was worked up for possible SLE and RA and Bone marrow biopsy was done for Cytopenias. While RA, ANF and Anti-DNA came out positive, thus bone marrow revealed hairy cell leukaemia, further conformed by immune histochemistry. Patient was started on steroids due to painful arthritis and discharged to be followed up after two weeks and mediation of treatment for HCL. Surprisingly, the CBC report reverted significantly during this period. Now the distinguishing point is, unlikely for hairy cell leukaemia to respond steroids so quickly within 10 days, or this was all SLE related manifestations and HCL was an incidental finding during the workup of pancytopenia. On further follow up we will do BRAF and flow cytometry for HCL.
Page(s): 78-79
DOI: DOI not available
Published: Journal: Annals of the Pakistan Institute of Medical Sciences, Volume: 17, Issue: 1, Year: 2021
Keywords:
splenomegaly , Arthritis , Cytopenias , Hepatomegaly
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