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Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo

A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also ha...

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Main Authors: Mimi Azreen Abdullah, Saleh Mohammed Abdullah Saleh Mohammed, Subbiah Vijay Kumar, Mohammad Zahirul Hoque
Format: Article
Language:English
Published: MDPI 2019
Subjects:
RC633-647.5 Diseases of the blood and blood-forming organs
RJ370-550 Diseases of children and adolescents
Online Access:https://eprints.ums.edu.my/id/eprint/42490/1/FULL%20TEXT.pdf
https://eprints.ums.edu.my/id/eprint/42490/
https://doi.org/10.4081/hr.2019.8167
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spelling my.ums.eprints.424902024-12-31T03:18:01Z https://eprints.ums.edu.my/id/eprint/42490/ Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo Mimi Azreen Abdullah Saleh Mohammed Abdullah Saleh Mohammed Subbiah Vijay Kumar Mohammad Zahirul Hoque RC633-647.5 Diseases of the blood and blood-forming organs RJ370-550 Diseases of children and adolescents A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also had non-neutropenic pyrexia spikes and oral ulcers. The patient was an adopted child; hence details about his biological parents’ previous history were unclear. Differential diagnosis of Chronic Myelomonocytic Leukemia (CMML), Juvenile Myelomonocytic Leukemia (JMML), Gaucher’s disease, Thalassemia and discrete pancreatic pathology was considered. Hemoglobin electrophoresis was indicative of thalassemia. Also, molecular detection method by polymerase chain reaction confirms a concurrent infection with Plasmodium knowlesi malaria. The BCR-ABL fusion gene was found to be negative. Correlating with peripheral monocytosis, bone marrow aspiration and trephine biopsy with blasts only 3-4% and hepatosplenomegaly, a diagnosis of JMML was established. We present a rare phenomenon with an overlap of signs and symptoms between JMML, underlying thalassemia, and Plasmodium knowlesi, posing a diagnostic challenge to physicians. MDPI 2019 Article NonPeerReviewed text en https://eprints.ums.edu.my/id/eprint/42490/1/FULL%20TEXT.pdf Mimi Azreen Abdullah and Saleh Mohammed Abdullah Saleh Mohammed and Subbiah Vijay Kumar and Mohammad Zahirul Hoque (2019) Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo. Hematology Reports 2019, 11. pp. 46-48. https://doi.org/10.4081/hr.2019.8167
institution Universiti Malaysia Sabah
building UMS Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sabah
content_source UMS Institutional Repository
url_provider http://eprints.ums.edu.my/
language English
topic RC633-647.5 Diseases of the blood and blood-forming organs
RJ370-550 Diseases of children and adolescents
spellingShingle RC633-647.5 Diseases of the blood and blood-forming organs
RJ370-550 Diseases of children and adolescents
Mimi Azreen Abdullah
Saleh Mohammed Abdullah Saleh Mohammed
Subbiah Vijay Kumar
Mohammad Zahirul Hoque
Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo
description A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also had non-neutropenic pyrexia spikes and oral ulcers. The patient was an adopted child; hence details about his biological parents’ previous history were unclear. Differential diagnosis of Chronic Myelomonocytic Leukemia (CMML), Juvenile Myelomonocytic Leukemia (JMML), Gaucher’s disease, Thalassemia and discrete pancreatic pathology was considered. Hemoglobin electrophoresis was indicative of thalassemia. Also, molecular detection method by polymerase chain reaction confirms a concurrent infection with Plasmodium knowlesi malaria. The BCR-ABL fusion gene was found to be negative. Correlating with peripheral monocytosis, bone marrow aspiration and trephine biopsy with blasts only 3-4% and hepatosplenomegaly, a diagnosis of JMML was established. We present a rare phenomenon with an overlap of signs and symptoms between JMML, underlying thalassemia, and Plasmodium knowlesi, posing a diagnostic challenge to physicians.
format Article
author Mimi Azreen Abdullah
Saleh Mohammed Abdullah Saleh Mohammed
Subbiah Vijay Kumar
Mohammad Zahirul Hoque
author_facet Mimi Azreen Abdullah
Saleh Mohammed Abdullah Saleh Mohammed
Subbiah Vijay Kumar
Mohammad Zahirul Hoque
author_sort Mimi Azreen Abdullah
title Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo
title_short Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo
title_full Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo
title_fullStr Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo
title_full_unstemmed Concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from Sabah, Malaysian Borneo
title_sort concurrent juvenile myelomonocytic leukemia with thalassemia in a case with plasmodium knowlesi infection from sabah, malaysian borneo
publisher MDPI
publishDate 2019
url https://eprints.ums.edu.my/id/eprint/42490/1/FULL%20TEXT.pdf
https://eprints.ums.edu.my/id/eprint/42490/
https://doi.org/10.4081/hr.2019.8167
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score 13.235362

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