Case Report

Volume: 4 | Issue: 5 | Published: Jun 11, 2020 | Pages: 166 - 169 | DOI: 10.24911/ejmcr/173-1583099876

Extramedullary hematopoiesis causing portal hypertension with chylous ascites in a patient with primary myelofibrosis


Authors: Vishal Mangal , Manish manrai , Ankit Kumar


Article Info

Authors

Vishal Mangal

Clinical Tutor, Department of Medicine, Armed Forces Medical College, Pune, India

Manish manrai

Assoc Professor, Department of Medicine, Armed Forces Medical College, Pune, India

Ankit Kumar

Junior Resident, Department of Medicine, Armed Forces Medical College, Pune, India

Publication History

Received: March 01, 2020

Revised: May 07, 2020

Accepted: May 18, 2020

Published: June 11, 2020


Abstract


Background: Primary myelofibrosis is a rare myeloproliferative disorder that is occasionally associated with abdominal and hepatic complications, such as Budd–Chiari syndrome, nodular regenerative hyperplasia, portal vein thrombosis, and rarely portal hypertension, which is found in 7% of the cases. Case Presentation: We report a rare case of portal hypertension with chylous ascites in a 49-year-old male patient with primary myelofibrosis, who presented with a painless progressive distension of the abdomen for 1 month. His transjugular liver biopsy revealed extramedullary hematopoiesis with colonies of erythroid precursors, megakaryocytes, and numerous clusters of erythroid islands in the hepatic sinusoids. He was provided with a salt-restricted diet and diuretics with partial response and was scheduled for a transjugular intrahepatic portosystemic shunt. Conclusion: Extramedullary hematopoiesis should always be considered in patients with myeloproliferative disorders with a rare case of portal hypertension.

Keywords: Myeloproliferative disorders, portal hypertension, chylous ascites, extramedullary hematopoiesis, primary myelofibrosis, case report, green