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Increased fracture rates in people with haemophilia: a 10‐year single institution retrospective analysis
Authors:Nathan D. Gay  Sarah C. Lee  Meghan S. Liel  Paul Sochacki  Michael Recht  Jason A. Taylor
Affiliation:1. Department of Medicine, Oregon Health & Science University, Portland, OR, USA;2. The Hemophilia Center, Oregon Health & Science University, Portland, OR, USA;3. Department of Pathology, Oregon Health & Science University, Portland, OR, USA;4. Portland Veterans Affairs Medical Center, Portland, OR, USA
Abstract:Sporadic essential thrombocythaemia (ET) is rare in paediatrics, and the diagnostic and clinical approach to paediatric cases cannot be simply copied from experience with adults. Here, we assessed 89 children with a clinical diagnosis of ET and found that 23 patients (25·8%) had a clonal disease. The JAK2 V617F mutation was identified in 14 children, 1 child had the MPL W515L mutation, and 6 had CALR mutations. The monoclonal X‐chromosome inactivation pattern was seen in six patients (two with JAK2 V617F and two with CALR mutations). The other 66 patients (74·2%) had persistent thrombocytosis with no clonality. There were no clinical or haematological differences between the clonal and non‐clonal patients. The relative proportion of ET‐specific mutations in the clonal children was much the same as in adults. The higher prevalence of non‐clonal cases suggests that some patients may not have myeloproliferative neoplasms, with significant implications for their treatment.
Keywords:haemophilia  fracture  bone disease  osteoporosis
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