Laboratory Findings

Although the majority of patients are generally well at the time of diagnosis, some present with symptoms related to anemia, neutropenia, or thrombocytopenia (Table 30.1). Pancytopenia is present in approximately half of the patients, and the remaining half usually exhibit a combination of cytopenias. In a series of 102 patients with HCL, 86 had anemia, 84 had thrombocytopenia, and 78 were neutropenic at the time of diagnosis.4 Approximately 25% of patients report weakness and fatigue, 25% suffer from opportunistic infections in the setting of neutropenia, and another quarter have easy bruising from thrombocytopenia. About 25% of patients are incidentally discovered to have splenomegaly or an abnormal peripheral blood count, at the time of evaluation for an unrelated con-dition.5

Coagulopathy, manifested by TTP and anti-factor VIII antibodies and paraproteinemia have been reported in patients with HCL.67

0 0

Post a comment