April 29, 2019


Case: 72-Year-Old Man Diagnosed With Primary Myelofibrosis

December 2018

  • A 72-year old man presents to primary care physician with complaints of fatigue, headache, night sweats, poor appetite, and 10-15lb weight loss over past few months; report of increased abdominal pain over the last 3 months
  • PMH: mild hypertension
  • PE: BP 130/85; Splenomegaly ~14 cm below left costal margin
  • Lab values:
    • HGB: 8.9 g/dL
    • Platelets: 189 x 109/L
    • WBC: 27.2 x 109/L
    • Serum LDH: 1500 U/L
    • Serum EPO: 11.5 mU/mL
  • Bone Marrow Biopsy:
    • MF-2
    • Circulating blasts, 1.2%
    • JAK-V617F mutation, del(20q)
  • Diagnosis: Primary myelofibrosis