Gürkan ATAY, Ertuğrul ERTAŞ, Bülent ALİOĞLU, Kemal KISMET, Saadet ÖZER, Erkut BAYRAM, Ahmet Şevki KARAKAYALI

AKUT MEZENTERİK VENÖZ TROMBOZ İLE PREZENTE OLAN BİR KRONİK LENFOSİTİK LÖSEMİ: OLGU SUNUMU

AMAÇ: Mezenterik ven trombozu (MVT) abdomenin küçük ve büyük damarlarının iskemi ve enfarktüsü ile karakterize nadir ancak önemli bir klinik durumudur. Bu yazıda hayatı tehdit eden MVT ile başvuran ve kronik lenfositik lösemi tanısı alan bir olgu sunulmuştur. OLGU: Yirmi sekiz yaşında erkek hasta MVT ileri tetkikleri ve yoğun bakım gereksinimi nedeniyle başka bir merkezden tarafımıza sevk edildi. Tam kan sayımında lenfositoz ile lökositoz dışında patolojik bulgu saptanmadı. Periferik kandan yapılan akış sitometri analizinde kronik lenfositik lösemi karakteristik göstergeleri olan (CD) 5 ve CD23 pozitifliği saptandı. Kemik iliği aspirasyonu ve biyopsisinde tanı teyid edildi. Tromboz ileri testleri normal bulundu. Hasta kronik lenfositik lösemi tedavisi için bir başka merkeze sevk edildi. SONUÇ: Bu olgu belirgin lökostitozu olmadan kronik lenfositik lösemi ile ilişkili MVT tanısı alan ilk olgudur. Mezenterik iskemi ile başvuran hastalarda kronik lenfositik löseminin de akılda tutulması gerektiğini vurgulamak isteriz.

CHRONIC LYMPHOCYTIC LEUKEMIA PRESENTED WITH LIFE-THREATENING ACUTE MESENTERIC VENOUS THROMBOSIS: A CASE REPORT

OBJECTIVE: Mesenteric venous thrombosis (MVT) is an uncommon but important clinical entity that can induce ischemia or infarction of the small and large bowel. Conditions associated with MVT consist of a wide spectrum of entities. This report describes a young patient with chronic lymphocytic leukemia who presented with life-threatening superior MVT. CASE: A 28-year-old man was referred to our hospital from a local state hospital after an operation due to MV for intensive care unit follow-up and further investigation of the cause of thrombosis. Initial hematologic tests disclosed that her complete blood count was within normal limits except leukocytosis with mature lymphocytosis. Peripheral blood flow cytometric analysis showed characteristic pattern of chronic lymphocytic leukemia (CLL), co-expression of cells surface markers cluster of differentiation (CD) 5 and CD23 molecules on the cell surface. Bone marrow aspiration also confirmed these findings. Other etiologic factors for thrombosis were within normal values. He diagnosed with CLL and was referred to another hematology department for treatment. CONCLUSION: This is the first report of acute MVT associated with CLL without marked hyperleukocytosis. We suggest that CLL should be kept in mind during the evaluation of the possible causes of mesenteric ischemia.

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