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Published on: June 20, 2018
Myelofibrosis in children with chronic renal insufficiency
Abstract:
During investigation of splenomegaly in a boy with chronic renal failure and osteodystrophy, bone marrow aspirates resulted in "dry taps," whereas biopsied material provided evidence that the marrow had been replaced by fibrous tissue. In a study of six other children with chronic renal failure, similar changes were observed. These findings suggest that the anemia of chronic renal failure may in part be a result of myelofibrosis, and the resulting reduction of functional bone marrow may limit the tolerance to immunosuppressive agents in patients who undergo renal transplantation.
Insights
Anemia in chronic renal failure may stem from myelofibrosis, a condition where bone marrow is replaced by fibrous tissue. This bone marrow scarring can impact treatment tolerance, especially after kidney transplants.
Area of Science:
- Nephrology
- Hematology
- Pathology
Background:
- Chronic renal failure (CRF) is associated with anemia and osteodystrophy.
- Bone marrow examination is crucial for diagnosing hematological disorders.
Purpose of the Study:
- To investigate the cause of splenomegaly and anemia in a boy with CRF.
- To examine bone marrow changes in children with CRF.
Main Methods:
- Bone marrow aspiration and biopsy were performed.
- Histopathological examination of biopsied bone marrow.
Main Results:
- Bone marrow aspirates yielded "dry taps" in affected children.
- Biopsied bone marrow showed replacement by fibrous tissue, indicating myelofibrosis.
- Splenomegaly was observed in conjunction with these bone marrow changes.
Conclusions:
- Anemia in CRF may be partly caused by myelofibrosis.
- Myelofibrosis reduces functional bone marrow capacity.
- Reduced bone marrow function may affect immunosuppressive therapy tolerance in renal transplant recipients.
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