Spinal Cord Compression Secondary to Extramedullary Hematopoiesis in Thalassemia

Backgroud/Objective: Extramedullary hematopoiesis (EMH) is a physiological response to chronic anemia and may rarely cause spinal cord compression. Herein, we describe 9 thalassemic patients presenting with signs and symptoms of cord compression either due to epidural mass or spinal canal stenosis secondary to bone widening. Since this emergency condition can be readily diagnosed by MRI and has medical rather than surgical treatment, i.e., blood transfusion and/or low dose radiation therapy, physicians should also be aware of EMH in patients with signs and symptoms of spinal cord compression, particularly in areas endemic for thalassemia. Results: 7 patients with thalasemia intermedia are treated medically and only by oral folic acid and symptoms disappeared within 2-3 weeks. “None of the seven patients were diagnosed before from point of thalassemia.” Two patients were diagnosed as major thalassemia. Conclusion: About young patient in endemic areas for thalassemia who have cord compression signs and symptoms, thalassemia variants or undiagnosed minor thalassemia should be evaluated.