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Case Reports
. 2019 Mar 23;12(3):e227199.
doi: 10.1136/bcr-2018-227199.

Unusual presentation of extramedullary haematopoiesis in a young boy

Pramod Darole  1 , Uma Sundar  1 , Nilesh Kuchekar  1 , Ajay Karre  1
Affiliations
Case Reports

Unusual presentation of extramedullary haematopoiesis in a young boy

Pramod Darole et al. BMJ Case Rep. .

Abstract

Acute transverse myelopathy in a young person may be due to infection, postinfective or inflammatory demyelination, or vascular causes. Rarely, a completely reversible cause of acute transverse myelopathy may be seen, as described here in our case of transverse myelopathy due to extramedullary haematopoiesis (EMH). An 18-year-old man who had a history of a lone blood transfusion at age of 7 years presented with paraplegia. MRI showed multiple epidural space masses of EMH compressing the spinal cord. He was detected to have thalassaemia intermedia and was treated with blood transfusions, steroids and radiotherapy to the involved paraspinal areas. He recovered fully over 15 days and remained symptom free at 6 months.

Keywords: haematology (incl blood transfusion); spinal cord.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
MRI T2W (T2-weighted) sagittal section showing intraspinal extradural soft tissue masses (white arrow) in thoracic spine region with compression of spinal cord.
Figure 2
Figure 2
MRI spine coronal section Short-T1 Inversion Recovery (STIR) image showing paraspinal masses in thoracic area.
Figure 3
Figure 3
T2 axial image (pretreatment) at D7 level showing compression of the spinal cord (blue arrow) by the intraspinal soft tissue.
Figure 4
Figure 4
MRI sagittal section of spine showing intraspinal extradural soft tissue masses (pink arrow) in sacral canal.
Figure 5
Figure 5
X-ray chest showing widening of posterior ends of ribs.
Figure 6
Figure 6
Post-radiotherapy MRI, T2 axial image at D6-7 level showing substantial reduction in the cord compression (black arrow). The inner image depicts the level of the spine at which this axial section is taken.
Figure 7
Figure 7
Postradiotherapy MRI spine STIR coronal section showing reduction in the paraspinal masses in thoracic area.
See this image and copyright information in PMC

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