Abstract
IntroductionWe report the case of a patient with Waldenstrom's macroglobulinemia complicated by spontaneous splenic rupture.Case presentationA 49-year-old Caucasian woman was referred to our emergency department by her general practitioner following a three-week history of malaise, night sweats, six kilograms of weight loss, intermittent nausea and vomiting, progressive upper abdominal pain and easy bruising. On the fourth day following her admission, she had a rapid clinical deterioration, with subsequent radiological investigations revealing a splenic rupture. Her morphology, biochemistry, flow cytometry and histology were strongly suggestive of Waldenstrom's macroglobulinemia.ConclusionsSpontaneous splenic rupture is not an expected complication of low-grade lymphoplasmacytic lymphomas, such as Waldenstrom's macroglobulinemia. To the best of our knowledge, this is the only reported case of early spontaneous splenic rupture due to Waldenstrom's macroglobulinemia. Our case highlights that despite the typical disease course of low-grade hematological malignancies, signs and symptoms of imminent splenic rupture should be considered when formulating a clinical assessment.
Highlights
We report the case of a patient with Waldenstrom’s macroglobulinemia complicated by spontaneous splenic rupture.Case presentation: A 49-year-old Caucasian woman was referred to our emergency department by her general practitioner following a three-week history of malaise, night sweats, six kilograms of weight loss, intermittent nausea and vomiting, progressive upper abdominal pain and easy bruising
We report the case of a patient with a spontaneous splenic rupture due to Waldenstrom’s macroglobulinemia (WM)
As mentioned previously an epidemiological link has been established between hepatitis C viral (HCV) infection and non-Hodgkin’s lymphoma (NHL), which is especially pronounced in Southern-European, Japanese, and Brazilian populations, conferring an estimated relative risk of 2.5 in the development of any NHL
Summary
Spontaneous splenic rupture is a complication of rapid disease progression, and is not an expected complication of low-grade LPLs, such as WM. To the best of our knowledge, this is the only reported case of early spontaneous splenic rupture due to WM. Our case report highlights that, despite the typical disease course of low-grade hematological malignancies, signs and symptoms of imminent splenic rupture should be considered when formulating a clinical assessment. Journal of Medical Case Reports 2010 4:300. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions MC and DJR are the sole authors and contributed to the production of this manuscript. All authors read and approved the final manuscript
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