Progressive Paraparesis due to Extramedullary Haematopoiesis in Thalassaemia Intermedia Treated Successfully with Radiotherapy: A Case Report

Abstract

Extramedullary Haematopoiesis (EMH), a rare complication of Thalassaemia Intermedia (TI), can present with pressure symptoms including Spinal Cord Compression (SCC) and can be treated using surgery, radiotherapy, hypertransfusion, or hydroxyurea. Hereby, the authors present a case report of a 20-year-old male young thalassaemic patient presented with progressive paraparesis. Neurological examination suggested SCC, and Magnetic Resonance Imaging (MRI) of the spine revealed paravertebral masses due to EMH. The patient was treated with radiotherapy to a dose of 30 Gy over three weeks. There was immediate, near-complete resolution of symptoms, and the patient could walk without assistance. He has been doing well since 1.5 years of treatment. So, in cases of TI, one should think of EMH as a differential diagnosis for paraparesis. Early clinicoradiological diagnosis of EMH-induced SCC is necessary and possible, as there is a high chance of complete remission of symptoms with radiotherapy, which is a non invasive and effective treatment option.

Keywords

• external beam radiotherapy
• magnetic resonance imaging
• spinal cord compression