Page 1 of 2: Most common cause of myelophthisic anaemia

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Most common cause of myelophthisic anaemia
a) Multiple myeloma
b) NHL
c) Leukaemia
d) Multiple secondaries.......a??

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) Leukaemia

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MYELOPHTHISIC ANEMIA IS PRODUCED BY SPACE OCCUPYING LESIONS DESTROYING MARROW AND AFFECTING ITS PRODUCTIVE CAPACITY.MOST COMMON CAUSE IS METASTATIC CANCER FROM BREAST,LUNG,PROSTATE,LUNG,ADRENALS.LEUKOERYTHROBLASTOSIS IS A COMMON FINDING

(REFERENCE ROBBINS PATHO BASIS OF DISEASE)

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multiple secondries

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myelophthisic anaemia --->

Myelophthisic Anemias

Fibrosis of the bone marrow (see Fig. 95-2), usually accompanied by a characteristic blood smear picture called leukoerythroblastosis, can occur as a primary hematologic disease, called myelofibrosis or myeloid metaplasia (Chap. 95), and as a secondary process, called myelophthisis. Myelophthisis, or secondary myelofibrosis, is reactive. Fibrosis can be a response to invading tumor cells, usually of an epithelial cancer of breast, lung, and prostate or neuroblastoma. Marrow fibrosis may occur with infection of mycobacteria (both Mycobacterium tuberculosis and M. avium), fungi, or HIV, and in sarcoidosis. Intracellular lipid deposition in Gaucher disease and obliteration of the marrow space related to absence of osteoclast remodeling in congenital osteopetrosis also can produce fibrosis. Secondary myelofibrosis is a late consequence of radiation therapy or treatment with radiomimetic drugs. Usually, the infectious or malignant underlying processes are obvious. Marrow fibrosis can also be a feature of a variety of hematologic syndromes, especially chronic myeloid leukemia, multiple myeloma, lymphomas, myeloma, and hairy cell leukemia.

The pathophysiology has three distinct features: proliferation of fibroblasts in the marrow space (myelofibrosis); the extension of hematopoiesis into the long bones and, most particularly, into extramedullary sites usually the spleen, liver, and lymph nodes (myeloid metaplasia); and ineffective erythropoiesis. The etiology of fibrosis is unknown but most likely involves dysregulated production of growth factors: platelet-derived growth factor and transforming growth factor have been implicated. Abnormal regulation of other hematopoietins would lead to localization of blood-producing cells in nonhematopoietic tissues and uncoupling of the usually balanced processes of stem cell proliferation and differentiation. Myelofibrosis is remarkable for pancytopenia despite extraordinarily large numbers of circulating hematopoietic progenitor cells.

Anemia is dominant in secondary myelofibrosis, usually normocytic and normochromic. The diagnosis is suggested by the characteristic leukoerythroblastic smear (see Fig. 95-1). Erythrocyte morphology is highly abnormal, with circulating nucleated red blood cells, teardrops, and shape distortions. White blood cell numbers are often elevated, sometimes mimicking a leukemoid reaction, with circulating myelocytes, promyelocytes, and myeloblasts. Platelets may be abundant and are often giant size. Inability to aspirate the bone marrow, the characteristic "dry tap," can allow a presumptive diagnosis in the appropriate setting before the biopsy is decalcified.

The course of secondary myelofibrosis is determined by its cause, usually a metastatic tumor or an advanced hematologic malignancy. Treatable causes must be excluded, especially tuberculosis and fungus. Transfusion support can relieve symptoms.

REF.--HARRISON.....
NOW WHAT SHOULD BE THE ANS.....U THINK & TELL ME....

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its secondaries....

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IT IS DEFINITELY THE SECONDARIES.
REGARDS.

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are we talkin about MYELOPLASTIC ANEMIA?

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