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Q. From the attached investigations, kindly explain the condition of the patient.

Answered by
Dr. Goswami Parth Rajendragiri
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 11, 2017 and last reviewed on: Aug 18, 2021

Hi doctor,

The patient was admitted due to eight episodes of hematemesis, weight loss and loss of appetite since last six months. It was accompanied by bone pain, abdominal pain, abdominal distension, jaundice, vomiting, altered bowel habit, fever, shortness of breath, decrease urine output or altered sensorium. Investigations the patient had are USG abdomen, UGI endoscopy, hemogram, liver function test, complete urine examination, differential WBC, smear study, microscopic examination, RT-PCR FOR BCR-ABL and esophageal biopsy.

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Hi,

Welcome to icliniq.com.

I had undergone the patient's reports (attachment removed to protect patient identity).

  • First of all, the patient has a tear in esophageal mucosa because of which bleeding occurred. To prevent bleeding, I suggest vasoconstrictor agent, adrenaline injection in the mucosa.
  • Barrett's esophagus also positive in histopathology report, but that is another issue for which regular screening was done.
  • Now, let me inform you your blood count was above 1.5 lakhs and the basophil is present in smear, which usually does not see in the smear. So, CML was suspected (chronic myelogenous leukemia) and molecular testing for translocation 9.22 that is BCR-ABL gene was done, and it is positive.
  • In this neoplasm, Imatinib mesylate tyrosine-kinase inhibitor drug must be prescribed along with other medication as per need like alpha interferon, Hydroxyurea, Busulfan, etc.
  • Without delay consult a nearby hematologist for examination and under his supervision start therapy. Take care.

For further information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist


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