Reversible therapy-related dysplastic hematopoiesis following Beta Interferon Therapy in Multiple Sclerosis Patients: Report of 2 Cases
A 35-year-old woman, with no significant previous illness, had a history of five-day diminished vision in the right eye followed by full recovery that had occurred seven years ago. Two years following the incident, she was apparently suffering from paresthesia and weakness in both lower limbs with left side predominance. Since MRI of the brain was compatible with MS, after ruling out other possibilities, she was diagnosed with a case of relapsing MS, for which she was treated with a course of intravenous methyl prednisolone over five days. Two years later, during laboratory follow up, the CBC showed a decrease in WBC and hemoglobulin levels (WBC: 2900dl, Hb: 9/9g/dl, platelet: 168.000dl). Interferon was stopped and hematology consultation was performed.\nBone marrow examinations confirmed dysplastic hematopoiesis; granulocytes displayed reduced segmentation (pseudo-Pelger-Huet abnormality) and reduced granulation.\nAfter treatment with conservative therapy, gradually all hematologic measures returned to the normal levels (WBC: 4000dl, Hb: 11.1g/dl, PLT: 193.000dl- 2010/10). Beta interferon was restarted and after two years, no abnormalities have been observed in the blood tests.