Dr. Mohite Aniket Balasaheb
Hematology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
May I please have your opinion about the downloaded pathology results taken during a hospital admission? A couple of years earlier, there was a firm diagnosis of JAK 2 overlap myeloproliferative or myelodysplastic disorder. In your view, do the pathology results indicate an acute transformation or a life-threatening hematological malignancy in some other way? There was no treatment for the overlap disorder while in hospital. However, the platelet count fell, and there was a suspicion of immune thrombocytopenia at one stage. There was type 2 diabetes, vitamin B12 deficiency, and COPD as well. Prednisone 40 mg daily was administered, but it was only after the cessation of the Prednisone that the platelet count normalized. Heparin was administered daily for several weeks.
Hi,
Welcome to icliniq.com.
I am sorry to say that the reports you have updated are, unfortunately, a document of COVID-19 (coronavirus disease 2019) information. Can you please give me more information about the same and send your detailed CBC (complete blood count) and marrow reports with JAK 2 (Janus Kinase 2 gene) panel details? I will be happy to help and discuss in more detail about your case.
Patient's Query
Hi doctor,
Thanks for the reply.
Please accept my apology for uploading the wrong file. I hope that this uploaded pathology report is of assistance.
Hi,
Welcome back to icliniq.com.
The reports you sent in the above attachment are eight years old with only CBC (complete blood count), liver function, and renal function tests (attachments removed to protect the patient's identity). Unfortunately, the infection markers are elevated as well. Please forward the reports of bone marrow tests and the tests of recent CBC, liver function tests, renal function tests, LDH (lactate dehydrogenase), ferritin, and CRP (c-reactive protein). Please review with reports.
Patient's Query
Hi doctor,
Thanks for the reply.
These are old test results. However, I merely wanted a second opinion about those old tests themselves. I appreciate that the information provided is minimal. But on the assumption that the overlap diagnosis is correct, would you say that there was evidence at the time of an acute transformation rather than an infection? And why? I realize that you are not in a position to be definitive.
Hi,
Welcome back to icliniq.com.
I do not think it is an acute leukemia transformation, and it needs further workup information if that is already done. The opinion that I can give based on your old reports is that it was related to infection. The reason for work up as JAK 2 positive is that it is a premalignant disease with a similar CBC picture, but the only difference would be an absence of infection. In your scenario, the CRP is high without infection but needs workup accordingly for the same as well. I think it was all infection-related, and now that you are well, I suppose it has settled down. Please consult if you do any further testing and report.
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Hematology
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