Chief complaint; I’ve been really tired lately.
Jeung, Man Ho is a 51 yo man who complains of shortness of breath on exertion, an unintentional weight loss of 10 kg, and fatigue beginning 4 months ago. He also notes fullness in his left upper quadrant and early satiety. He has married and lives with his wife of 30 years. He works full-time and smoked 1/2 to 1/4 pack of cigarettes/day for over 20 years until he quit 4 years ago. He feels occasional fever, chills, and night sweats, shortness of breath on exertion. Denies bleeding, headaches, nausea, vomiting, chest pain, or urinary symptoms. Abdominal test showed spleen palpable 8 cm below costal margin. No hepatomegaly noted. Cytogenetic studies performed on a bone marrow biopsy revealed a translocatin involving the long arms of chromosomes 9 and 22.
9번 22번이니까 필라델피아... CML 같긴 한데요
어떤 질병인지와
좀 자세한 설명 부탁드립니다.
예를블면 spleen의 palpation은 ~~ 때문에 그렇고...등등..
너무 바쁘신관계로 자세한 답변이 불가하시다면 찾아볼만한 사이트라도..
그것마저도 불가하시다면 질환이라도...
부탁드립니다.
Jeung, Man Ho is a 51 yo man who complains of shortness of breath on exertion, an unintentional weight loss of 10 kg, and fatigue beginning 4 months ago. He also notes fullness in his left upper quadrant and early satiety. He has married and lives with his wife of 30 years. He works full-time and smoked 1/2 to 1/4 pack of cigarettes/day for over 20 years until he quit 4 years ago. He feels occasional fever, chills, and night sweats, shortness of breath on exertion. Denies bleeding, headaches, nausea, vomiting, chest pain, or urinary symptoms. Abdominal test showed spleen palpable 8 cm below costal margin. No hepatomegaly noted. Cytogenetic studies performed on a bone marrow biopsy revealed a translocatin involving the long arms of chromosomes 9 and 22.
9번 22번이니까 필라델피아... CML 같긴 한데요
어떤 질병인지와
좀 자세한 설명 부탁드립니다.
예를블면 spleen의 palpation은 ~~ 때문에 그렇고...등등..
너무 바쁘신관계로 자세한 답변이 불가하시다면 찾아볼만한 사이트라도..
그것마저도 불가하시다면 질환이라도...
부탁드립니다.
참고:
The clinical manifestations of CML are insidious and are often discovered incidentally when an elevated WBC count is revealed by a routine blood count or when an enlarged spleen is revealed during a general physical examination.
Nonspecific symptoms of tiredness, fatigue, and weight loss may occur long after the onset of the disease. Loss of energy and decreased exercise tolerance may occur during the chronic phase after several months.
Patients often have symptoms related to enlargement of the spleen, liver, or both.
The large spleen may encroach on the stomach and cause early satiety and decreased food intake. Left upper quadrant abdominal pain described as "gripping" may occur from spleen infarction. The enlarged spleen may also be associated with a hypermetabolic state, fever, weight loss, and chronic fatigue.
The enlarged liver may contribute to the patient's weight loss.
Splenomegaly is the most common physical finding in patients with CML.
In more than half the patients with CML, the spleen extends more than 5 cm below the left costal margin at time of discovery.
The size of the spleen correlates with the peripheral blood granulocyte counts (see Image 2), with the biggest spleens being observed in patients with high WBC counts.
A very large spleen is usually a harbinger of the transformation into an acute blast crisis form of the disease.
Hepatomegaly also occurs, although less commonly than splenomegaly. Hepatomegaly is usually part of the extramedullary hematopoiesis occurring in the spleen.
Reference: http://en.wikipedia.org/wiki/Philadelphia_chromosome
http://www.emedicine.com/med/topic371.htm (무료 가입 필요)
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항상 말하듯이 본인은 답변의 정확성 및 내용에 대한 아무런 책임을 지지 않으며, 참고사항으로 답변을 제공합니다.
책들을 찾다 보니 shortness of breath on exertion에대해선 언급이 없는데요 이것도 LUQ pain처럼 splenomegaly때문인가요?
좋은 하루 되세요
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항상 말하듯이 본인은 답변의 정확성 및 내용에 대한 아무런 책임을 지지 않으며, 참고사항으로 답변을 제공합니다.