Myeloproliferative Disease Clinical Presentation

Updated: Nov 26, 2019
  • Author: Haleem J Rasool, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Presentation

History

Presenting complaints in patients with myeloproliferative neoplasms include the following:

  • Easy fatigability

  • Anorexia, weight loss

  • Abdominal discomfort and early satiety secondary to splenomegaly is more common in chronic myelogenous leukemia and primary myelofibrosis

  • Easy bruising, bleeding, and/or symptoms of thrombosis

  • Swollen, painful joint(s) secondary to gouty arthritis secondary to hyperuricemia

  • Priapism, tinnitus, or stupor from leukostasis

  • Left upper quadrant and left shoulder pain as a consequence of splenic infarction and perisplenitis

  • In many patients, abnormal blood counts are noted on a blood test performed for other reasons.

A study by Scherber et al assessed the use of an 18-item assessment form called the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF), which is completed by the patient and is designed to assess symptoms of myelofibrosis, essential thrombocythemia, and polycythemia vera. The study found that the MPN-SAF is a comprehensive and reliable instrument that correlated well with physicians’ blinded opinion of patient symptoms. [20]

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Physical Examination

Physical examination findings in patients with myeloproliferative disease may include the following:

  • Pallor, except in patients with polycythemia vera

  • Plethora secondary to polycythemia

  • Petechiae and/or ecchymosis

  • Palpable spleen and/or liver

  • Occasionally, a syndrome of fever accompanied by painful maculopapular violaceous lesions on trunk, arms, legs, and face, which is called acute febrile neutrophilic dermatosis or Sweet syndrome

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