Pseudo-Pelger–Huët anomaly and granulocytic dysplasia associated with human granulocytic anaplasmosis

Pseudo-Pelger–Huët anomaly (PHA) refers to mono- or bi-lobed granulocytes, reportedly observed in patients with severe infections and inflammation or hematological malignancies including myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). Dysplastic changes in granulocytes are typical ma...

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Published inInternational journal of hematology Vol. 102; no. 1; pp. 129 - 133
Main Authors Lee, Sunyoung, Khankhanian, Pouya, Salama, Carlos, Brown, Maritza, Lieber, Joseph
Format Journal Article
LanguageEnglish
Published Tokyo Springer Japan 01.07.2015
Springer Nature B.V
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Abstract Pseudo-Pelger–Huët anomaly (PHA) refers to mono- or bi-lobed granulocytes, reportedly observed in patients with severe infections and inflammation or hematological malignancies including myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). Dysplastic changes in granulocytes are typical manifestations in MDS and granulocytic leukemias. Here, we report the unique case of a patient found to have human granulocytic anaplasmosis (HGA), a tick-borne disease caused by Anaplasma phagocytophilum , a Gram-negative coccobacillus. This patient showed striking hematological manifestations including a large number of pseudo-PHA, a severe degree of left shift, and dysplastic granulocytes. These hematological presentations on the peripheral smear all resolved with doxycycline treatment, implying that the changes were most likely reactive manifestations secondary to HGA, rather than underlying hematological malignancies such as MDS or AML.
AbstractList Pseudo-Pelger–Huët anomaly (PHA) refers to mono- or bi-lobed granulocytes, reportedly observed in patients with severe infections and inflammation or hematological malignancies including myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). Dysplastic changes in granulocytes are typical manifestations in MDS and granulocytic leukemias. Here, we report the unique case of a patient found to have human granulocytic anaplasmosis (HGA), a tick-borne disease caused by Anaplasma phagocytophilum , a Gram-negative coccobacillus. This patient showed striking hematological manifestations including a large number of pseudo-PHA, a severe degree of left shift, and dysplastic granulocytes. These hematological presentations on the peripheral smear all resolved with doxycycline treatment, implying that the changes were most likely reactive manifestations secondary to HGA, rather than underlying hematological malignancies such as MDS or AML.
Pseudo-Pelger–Huët anomaly (PHA) refers to mono- or bi-lobed granulocytes, reportedly observed in patients with severe infections and inflammation or hematological malignancies including myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). Dysplastic changes in granulocytes are typical manifestations in MDS and granulocytic leukemias. Here, we report the unique case of a patient found to have human granulocytic anaplasmosis (HGA), a tick-borne disease caused by Anaplasma phagocytophilum, a Gram-negative coccobacillus. This patient showed striking hematological manifestations including a large number of pseudo-PHA, a severe degree of left shift, and dysplastic granulocytes. These hematological presentations on the peripheral smear all resolved with doxycycline treatment, implying that the changes were most likely reactive manifestations secondary to HGA, rather than underlying hematological malignancies such as MDS or AML.
Author Salama, Carlos
Lieber, Joseph
Lee, Sunyoung
Khankhanian, Pouya
Brown, Maritza
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  surname: Lee
  fullname: Lee, Sunyoung
  email: syandsy@gmail.com, sunyoung.s.lee@mssm.edu
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Keywords Pseudo-Pelger–Huët anomaly
Human granulocytic anaplasmosis
Dysplastic granulocytes
Tick-borne disease
Language English
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PublicationTitle International journal of hematology
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Springer Nature B.V
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Snippet Pseudo-Pelger–Huët anomaly (PHA) refers to mono- or bi-lobed granulocytes, reportedly observed in patients with severe infections and inflammation or...
Pseudo-Pelger-Huët anomaly (PHA) refers to mono- or bi-lobed granulocytes, reportedly observed in patients with severe infections and inflammation or...
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springer
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StartPage 129
SubjectTerms Acute myeloid leukemia
Adult
Anaplasma phagocytophilum
Anaplasmosis
Anaplasmosis - diagnosis
Anaplasmosis - drug therapy
Anaplasmosis - microbiology
Case Report
Diagnosis, Differential
Doxycycline
Dysplasia
Granulocytes - pathology
Hematology
Humans
Leukemia
Leukocytes (granulocytic)
Male
Medicine
Medicine & Public Health
Myelodysplastic syndrome
Myeloid leukemia
Neutrophils - pathology
Oncology
Parasitic diseases
Patients
Pelger-Huet Anomaly - diagnosis
Tick-borne diseases
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Title Pseudo-Pelger–Huët anomaly and granulocytic dysplasia associated with human granulocytic anaplasmosis
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