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Unexplained dyspnoea in a patient with idiopathic myelofibrosis
  1. Praveen Pissay Gopala Rao1,
  2. Rachel Buxton-Thomas2,
  3. Brendan Tinwell3,
  4. Adrian Draper2,
  5. Johnny Vlahos1,
  6. Simon L F Walsh4
  1. 1Department of Radiology, St George's Hospital, London, UK
  2. 2Department of Respiratory Medicine, St George's Hospital, London, UK
  3. 3Department of Histopathology, St George's Hospital, London, UK
  4. 4Department of Radiology, Royal Brompton Hospital, London, UK
  1. Correspondence to Dr Praveen Pissay Gopala Rao, Department of Radiology, St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK; drpgpraveen{at}

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A 41-year-old with idiopathic myelofibrosis was referred to the chest clinic with a 1-month history of progressive dyspnoea and intermittent wheeze. There was no history of haemoptysis and the patient was a lifelong non-smoker. On examination, the patient was afebrile, cachectic and had hepatosplenomegaly. Haemoglobin was 6.0 g/dl, white cell count 3.6×109/l, platelet count 98×109/l. Blood smear showed marked anisopoikilocytes, prominent tear drop cells and polychromasia. Bone marrow aspirate was hypercellular, showed reduction in the degree of maturation, and a marked decrease in the proportion of erythroid cells. There was no evidence of acute leukaemia or metastatic malignancy. Microbiologic analysis of the sputum and blood for pulmonary infection was negative. Lung function test showed a restrictive …

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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