A Case of Chronic Thrombocytopenia in a 17-Year-Old Female

Author:

Riley Roger1,Khan Asad2,Pai Shella1,Warmke Laura3,Winkler Marcus4,Gunning William5

Affiliation:

1. Departments of Pathology, Virginia Commonwealth University (VCU) School of Medicine, Richmond

2. Departments of Pediatrics, Virginia Commonwealth University (VCU) School of Medicine, Richmond

3. Department of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston

4. Associated Pathologists, Nashville, TN

5. Department of Pathology, University of Toledo College of Medicine, Toledo, Ohio

Abstract

AbstractStorage pool deficiency (SPD) is a group of rare platelet disorders that result from deficiencies in α-granules, δ-granules, or both. One type of α-SPD is gray platelet syndrome (GPS), caused by mutations in the neurobeachin-like 2 (NBEAL2) gene that results in a bleeding diathesis, thrombocytopenia, splenomegaly, and progressive myelofibrosis. Due to the lack of α-granules, platelets have a gray and degranulated appearance by light microscopy. However, definitive diagnosis of GPS requires confirmation of α-granule deficiency by electron microscopy. Treatment is nonspecific, with the conservative utilization of platelet transfusions being the most important form of therapy. We present a case of a 17-year-old female with a past medical history of thrombocytopenia, first identified at the age of five. Her clinical symptomatology included chronic fatigue, gingival bleeding, bruising, menorrhagia, and leg pain. This report will discuss both the clinical and the pathophysiologic aspects of this rare platelet disorder.

Publisher

Oxford University Press (OUP)

Subject

Biochemistry, medical,Clinical Biochemistry

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