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library name : انستیتو تغذیه دانشگاه علوم پزشکی شهید بهشتی
Material Type : Latin Articles
Language of Document : English
Record Number : 62047
Doc. No : 707A
Main Entry : VALIZADEH NASIM
Title & Author : MYELOFIBROSIS DUE TO SECONDARY HYPERPARATHYROIDISM IN A CASE OF CELIAC DISEASE [Article]; AGHAMOHAMMADI N.
Title : INTERNATIONAL JOURNAL OF HEMATOLOGY-ONCOLOGY AND STEM CELL RESEARCH (IJHOSCR)
Volume Number : , Vol.3 ؛ No.4
Date : , (2009)
page : : 25 - 25
Abstract : Background: Myelofibrosis is reported in patients with primary hyperparathyroidism. It is also was reported in patients with secondary hyperparathyroidism due to end-stage renal disease or Vitamin D dependent rickets We want to present a case of celiac disease and osteomalacia which leads to secondary hyperparathyroidism and myelofibrosis.Case Report: An 18 y/o female admitted in hematologic department with pancytopenia and splenomegaly. She had positive history of chronic diarrhea since childhood and secondary amenorrhea. Physical exam revealed short stature, clubbing, splenomegaly and failure of development of secondary sexual characteristics.Laboratory data revealed: pancytopenia, White blood cells )WBC(=1400, Hemoglobin )Hb(=7.1, Mean corpuscular volume )MCV(=86, platelets count )Plt(=52, 000, hypokalemia, hypocalcemia, hypophosphatemia, with marked rised in prarathyroid hormone )PTH( level and normal serum albumin and Immunoglobulin A )IgA(. Follicle Stimulating Hormone )FSH( and Lutenising Hormone )LH( were decreased. Alanine aminotransferase )ALT( was in normal ranges and Aspartate aminotransferase )AST(, Alkaline phosphotase )AlK Ph( and Direct &total Bill irubin were rised mildly. Serum folate and B12 and ferritin levels all were decreased. Urine analysis and stool exam and thyroid function tests all were normal.Anti- Endomyosial Antibody )IgA(=170 U/ml )High, Normal<10(. Abdominal ultrasound revealed: Hepatomegaly, Hudge splenomegaly and portal hypertention. Peripheral blood smear: Anisocytosis, Poikylocytosis, Many macrocyte, Many Microcyte, Many tear drop, Hypochromia and hyper segmented PMNs.Bone marrow aspiration and biopsy revealed myelofibrosis. Upper GI endoscopy revealed fissuring in duodenal second part and biopsy showed marked mucosal flattening and villous athrophy.Diagnosis of Celiac disease and secondary hyper parathyroidism which leads to myelofibrosis was made.Results: In this case with celiac disease and osteomalacia which leads to secondary hyperparathyroidism we found increased in number of giant cells and osteoclasts in bone marrow and secondary myelofibrosis. Conclusion: Patients with celiac disease and osteomalacia are susceptible to secondary hyperparathyroidism which may leads to myelofibrosis. Cases of celiac disease with pancytopenia and organomegaly should be evaluated for evidences of secondary hyperparathyroidism and myelofibrosis. It is required to searching for hyperparathyroidism in all patients with celiac disease and myelofibrosis.
Descriptor : CELIAC DISEASE
Descriptor : HYPERPARATHYROIDISM
Descriptor : MYELOFIBROSIS
Added Entry : VALIZADEH N
: NATEGHI SH
 
 
 
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