Table of Contents    
Case Report
 
Myelofibrosis secondary to tuberculosis in a child with Down's syndrome: A case report
Prem Singh1, Ankita Goyal1, Deeba Mushtaq1, Jyoti Bala1
1Department of Pathology, M M Institute of Medical Sciences and Research, Mullana (Ambala), Haryana, India - 133207.

doi:10.5348/ijcri-2012-07-148-CR-9

Address correspondence to:
Dr. Prem Singh
Department of Pathology, M M Institute of Medical Sciences and Research
Mullana (Ambala)
Haryana
India - 133207
Phone: 08950204113
Email: premsingh011@rediffmail.com

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How to cite this article:
Singh P, Goyal A, Mushtaq D, Bala J. Myelofibrosis secondary to tuberculosis in a child with Down's syndrome : A case report. International Journal of Case Reports and Images 2012;3(7):35–38.


Abstract
Introduction: Tuberculosis and myelofibrosis (MF) are reported to co-exist. There seems to be a definite relationship between the two entities, possibly tuberculosis stimulating a secondary fibrotic reaction. Occurrence of myelofibrosis in Down's syndrome has also been increasingly recognized. The purpose of this article is to present a unique case of Down's syndrome who developed myelofibrosis secondary to tuberculosis of the bone marrow.
Case Report: A 14-years-old female child, already a documented case of Down's syndrome, proved on cytogenetic analysis, reported to our institute with fever of five days duration and bleeding from nose and mouth. Clinical examination revealed features of Down's syndrome and hematological parameters showed pancytopenia. Bone marrow aspiration revealed a dry tap. Bone marrow biopsy showed hypocellular marrow with tubercular granulomas and increased bone marrow reticulin fibres, findings compatible with myelofi brosis secondary to tuberculosis.
Conclusion: Myelofibrosis in paediatric age group is usually secondary to an underlying disease entity of haematopoietic or non- haematopoietic origin. Among the non- haematopoietic diseases, tuberculosis shows a frequent association. Moreover, the patients of Down's syndrome have disturbances of hematopoiesis with an increased incidence of myeloproliferative disorders like myelofibrosis. Such patients suffering from other diseases like tuberculosis are more prone to develop myelofibrosis as seen from the present case report. A detailed investigation and extensive search for evidence of tuberculosis should be made in these children presenting with myelofibrosis.

Key Words: Myelofibrosis, Tuberculosis, Down's syndrome

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Author Contributions:
Prem Singh - Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Ankita Goyal - Analysis and interpretation of data, Conception and design, Critical revision of the article, Final approval of the version to be published
Deeba Mushtaq - Acquisition of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Jyoti Bala - Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of submission.
Source of support:
None
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© Prem Singh et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)