images in haematology
Massive splenomegaly in post-polycythaemic myelofibrosis causing overactive bladder syndrome
An 81-year-old female with a longstanding history of postpolycythaemic myelofibrosis and splenomegaly presented with symptoms of overactive bladder syndrome (urgency, urge incontinence). Her blood tests revealed Hb 85 g/l, white blood cell count 66 9 109/l and platelet count 91 9 109/l. Urological work-up (cystoscopy, urodynamic studies) did not reveal an intrinsic cause to explain the symptomatology. Computed tomography (CT) scanning of abdomen and pelvis demonstrated massive splenomegaly (27 cm in maximum craniocaudal length) with the inferior margin abutting the dome of the bladder. Previous treatments for the underlying
First published online 21 May 2014 doi: 10.1111/bjh.12949
haematological disorder had included venesection, hydroxycarbamide, radioactive phosphorus, lenalidomide and radiotherapy. The patient was offered a trial of the novel JAK2 inhibitor, ruxolitinib, but after full discussion, declined this agent. She received tolderodine tartate modified release (4 mg/d) with some improvement in symptoms. Matt Goodyer1, Donald McCarthy1 and Risteard O’Laoide2 1
Department of Haematology, St Vincent’s University Hospital, and
2
Department of Radiology, St Vincent’s University Hospital, Dublin,
Ireland. E-mail: [email protected]
ª 2014 John Wiley & Sons Ltd British Journal of Haematology, 2014, 166, 310–310
Massive splenomegaly in post-polycythaemic myelofibrosis causing overactive bladder syndrome
An 81-year-old female with a longstanding history of postpolycythaemic myelofibrosis and splenomegaly presented with symptoms of overactive bladder syndrome (urgency, urge incontinence). Her blood tests revealed Hb 85 g/l, white blood cell count 66 9 109/l and platelet count 91 9 109/l. Urological work-up (cystoscopy, urodynamic studies) did not reveal an intrinsic cause to explain the symptomatology. Computed tomography (CT) scanning of abdomen and pelvis demonstrated massive splenomegaly (27 cm in maximum craniocaudal length) with the inferior margin abutting the dome of the bladder. Previous treatments for the underlying
First published online 21 May 2014 doi: 10.1111/bjh.12949
haematological disorder had included venesection, hydroxycarbamide, radioactive phosphorus, lenalidomide and radiotherapy. The patient was offered a trial of the novel JAK2 inhibitor, ruxolitinib, but after full discussion, declined this agent. She received tolderodine tartate modified release (4 mg/d) with some improvement in symptoms. Matt Goodyer1, Donald McCarthy1 and Risteard O’Laoide2 1
Department of Haematology, St Vincent’s University Hospital, and
2
Department of Radiology, St Vincent’s University Hospital, Dublin,
Ireland. E-mail: [email protected]
ª 2014 John Wiley & Sons Ltd British Journal of Haematology, 2014, 166, 310–310
