J. Dierick MD

An unusual mononucleosis infectiosa-like illness caused by toxoplasmosis in a B-cell chronic lymphocytic leukaemia patient

The differential diagnosis of mononucleosis infectiosa (Ml)-like illness can be challenging since several infectious causes have been identified to date. The most common associated pathogen is Epstein-Barr virus, followed by cytomegalovirus, human immunodeficiency virus type 1 and human herpesvirus-6. Ml-like illness is rather rarely caused by Toxoplasma gondii, a parasite that is transmitted through consumption of undercooked food or contact with faeces from infected cats. In this case report, we discuss a B-cell chronic lymphocytic leukaemia patient with a Ml-like illness caused by toxoplasmosis.

(BELG J HEMATOL 2019;10(3):122–6)

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Immune-mediated early-onset neonatal thrombocytopenia: a double case presentation

Summary

Neonatal thrombocytopenia comprises a platelet count of less than 150×10⁹/L, with severe neonatal thrombocytopenia in case of a platelet count less than 50×10⁹/L. Severe thrombocytopenia is an uncommon finding in newborns requiring immediate diagnostic work-up with the need for urgent intervention to avoid severe bleeding complications. Neonatal thrombocytopenia can be classified by time of onset in early-onset (<72h after birth) versus late-onset (>72h after birth) thrombocytopenia. Multiple causes may be involved. In term, otherwise healthy neonates, one important cause of early-onset thrombocytopenia is antibody-mediated platelet destruction, and this can be allo- or auto-immune-mediated. In this case presentation, we discuss two neonates with severe early-onset immune-mediated thrombocytopenia presenting simultaneously at our general hospital.

(BELG J HEMATOL 2016;7(5):188–93)

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Splenic infarction due to severe hemoconcentration in a case of systemic capillary leak syndrome (Clarkson’s disease)

Summary

Systemic capillary leak syndrome is a potentially fatal disorder characterised by transient but severe hypotension, resulting in vascular collapse and shock, in combination with extreme hemoconcentration and anasarca oedema accompanied by a monoclonal gammopathy of unknown significance. We describe a case of Clarkson’s disease, complicated with severe hemoconcentration leading to splenic infarction and pulmonary oedema treated with ultrafiltration. The pathogenesis of systemic capillary leak syndrome remains unknown. We determined the serum concentration of soluble mediators erythropoietin and vascular endothelial growth factor, in order to attribute their role in the underlying pathophysiology of the disease.

(BELG J HEMATOL 2015;6(1):33–6)

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