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Hematology Reports
Volume 11
Issue 3
10.4081/hr.2019.8167
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Hematology Reports is published by MDPI from Volume 14 Issue 1 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

Concurrent Juvenile Myelomonocytic Leukemia with Thalassemia in a Case with Plasmodium knowlesi Infection from Sabah, Malaysian Borneo

by
Mimi Azreen Abdullah
1,
Saleh Mohammed Abdullah
2,
Subbiah Vijay Kumar
3 and
Mohammad Zahirul Hoque
4,5,*
1
Department of Pathology, Sabah Women and Children Hospital, Kota Kinabalu 88996, Sabah, Malaysia
2
Department of Medical Laboratory, Faculty of Applied Medical Sciences, Jazan University, Jazan 82621, Saudi Arabia
3
Biotechnology Research Institute, University Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
4
Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
5
Faculty of Medicine & Health Sciences, University Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2019, 11(3), 8167; https://doi.org/10.4081/hr.2019.8167
Submission received: 6 May 2019 / Revised: 1 June 2019 / Accepted: 18 June 2019 / Published: 24 June 2019

Abstract

A 3-year-old male child was presented with worsening abdominal pain, abdominal distension, lethargy, pallor and hepatosplenomegaly. The patient had multiple outpatient visits in the past and was treated with oral antibiotics, oral anthelmintic agents, albeit with minimal benefit. The patient also had non-neutropenic pyrexia spikes and oral ulcers. The patient was an adopted child; hence details about his biological parents’ previous history were unclear. Differential diagnosis of Chronic Myelomonocytic Leukemia (CMML), Juvenile Myelomonocytic Leukemia (JMML), Gaucher’s disease, Thalassemia and discrete pancreatic pathology was considered. Hemoglobin electrophoresis was indicative of thalassemia. Also, molecular detection method by polymerase chain reaction confirms a concurrent infection with Plasmodium knowlesi malaria. The BCR-ABL fusion gene was found to be negative. Correlating with peripheral monocytosis, bone marrow aspiration and trephine biopsy with blasts only 3–4% and hepatosplenomegaly, a diagnosis of JMML was established. We present a rare phenomenon with an overlap of signs and symptoms between JMML, underlying thalassemia, and Plasmodium knowlesi, posing a diagnostic challenge to physicians.
Keywords: chronic myelomonocytic leukemia; juvenile myelomonocytic leukemia; thalassemia chronic myelomonocytic leukemia; juvenile myelomonocytic leukemia; thalassemia

Share and Cite

MDPI and ACS Style

Abdullah, M.A.; Abdullah, S.M.; Kumar, S.V.; Zahirul Hoque, M. Concurrent Juvenile Myelomonocytic Leukemia with Thalassemia in a Case with Plasmodium knowlesi Infection from Sabah, Malaysian Borneo. Hematol. Rep. 2019, 11, 8167. https://doi.org/10.4081/hr.2019.8167

AMA Style

Abdullah MA, Abdullah SM, Kumar SV, Zahirul Hoque M. Concurrent Juvenile Myelomonocytic Leukemia with Thalassemia in a Case with Plasmodium knowlesi Infection from Sabah, Malaysian Borneo. Hematology Reports. 2019; 11(3):8167. https://doi.org/10.4081/hr.2019.8167

Chicago/Turabian Style

Abdullah, Mimi Azreen, Saleh Mohammed Abdullah, Subbiah Vijay Kumar, and Mohammad Zahirul Hoque. 2019. "Concurrent Juvenile Myelomonocytic Leukemia with Thalassemia in a Case with Plasmodium knowlesi Infection from Sabah, Malaysian Borneo" Hematology Reports 11, no. 3: 8167. https://doi.org/10.4081/hr.2019.8167

APA Style

Abdullah, M. A., Abdullah, S. M., Kumar, S. V., & Zahirul Hoque, M. (2019). Concurrent Juvenile Myelomonocytic Leukemia with Thalassemia in a Case with Plasmodium knowlesi Infection from Sabah, Malaysian Borneo. Hematology Reports, 11(3), 8167. https://doi.org/10.4081/hr.2019.8167

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