Case and Research Letter
Transient Myeloproliferative Syndrome Associated With Down Syndrome
Síndrome mieloproliferativo transitorio asociado a síndrome de Down
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The ruptured lesions appear as pigmented macules.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Agusti-Mejias, F. Messeguer, I. Febrer, V. Alegre" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Agusti-Mejias" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Messeguer" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Febrer" ] 3 => array:2 [ "nombre" => "V." 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Borregón, J. Menárguez, N. Navarro, M. Campos" "autores" => array:4 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Borregón" "email" => array:1 [ 0 => "paloma_borregon@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Menárguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "N." "apellidos" => "Navarro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Campos" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicios de Dermatología, Anatomía Patológica, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicios de Dermatología, Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome mieloproliferativo transitorio asociado a síndrome de Down" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1198 "Ancho" => 1585 "Tamanyo" => 149519 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vesiculopustular lesions predominantly on the face and, to a lesser extent, the torso.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">To the Editor:</span></p><p id="par0005" class="elsevierStylePara elsevierViewall">Transient myeloproliferative syndrome (TMPS) is a usually self-limiting hematologic syndrome characterized by the proliferation of myeloblasts in peripheral blood and bone marrow; it affects neonates with Down syndrome. It may be associated with skin lesions and so differential diagnosis with other vesiculopustular rashes may be required.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a full-term baby girl with Down syndrome and a vesiculopustular rash located predominantly on the face, with lesions distributed unevenly on the face, scalp, and torso (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No prenatal tests were performed until the second half of the pregnancy, when ultrasound revealed mild heart abnormalities. Down syndrome was confirmed by karyotype in the first week of life. Tests carried out in the first week of life showed the following results: hemoglobin, 22.7<span class="elsevierStyleHsp" style=""></span>g/dL; platelets, 46 000/μL; and leukocytes, 49 000/μL, with 28% blasts in blood. Cultures for bacteria, fungi, and viruses were negative. A smear of one of the pustules showed intermediate mature granulocytic elements and some blasts. The bone marrow showed no signs of leukemia. A skin biopsy revealed a subcorneal vesicular pustule filled with polymorphonuclear leukocytes and epidermal exocytosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Both the blood and skin abnormalities resolved spontaneously in the first weeks of life.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">TMPS associated with Down syndrome is a self-limiting condition that presents with blasts in the peripheral blood, erythrocytosis, thrombopenia, and coagulation disorders.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It may or may not cause skin lesions, which consist of vesicular pustules initially grouped on the head and later extending to the torso; these lesions may present the Koebner response and appear in areas susceptible to rubbing or pressure. Pathogenesis involves mutations of the <span class="elsevierStyleItalic">GATA-1</span> gene.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The differential diagnosis should include diseases that present vesicular-pustular rashes in neonates<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), whether infectious, such as congenital candidiasis, impetigo, scabies, scalded skin syndrome, or herpes, or noninfectious, such as miliaria, toxic erythema, transient neonatal pustular melanosis, neonatal acne, blistering autoimmune diseases, epidermolysis bullosa, urticaria pigmentosa, or incontinentia pigmenti. In general, no treatment is required, other than support measures and follow-up, owing to the increased risk of developing acute leukemia in the first years of life<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1-3</span></a>; however, chemotherapy drugs such as cytosine arabinoside and, more recently, rasburicase have been used in severe forms.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion, this entity should be taken into account when diagnosing vesiculopustular rashes in neonates. TMPS associated with Down syndrome is a rare condition that presents with blasts in the peripheral blood, erythrocytosis, thrombopenia, and coagulation disorders. Although treatment is generally not required, the patient should be followed up for several years, owing to the increased risk of leukemia during this time.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Borregón P, et al. Síndrome mieloproliferativo transitorio asociado a síndrome de Down. Actas Dermosifiliograf.2013;104:82–3.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1198 "Ancho" => 1585 "Tamanyo" => 149519 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vesiculopustular lesions predominantly on the face and, to a lesser extent, the torso.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1913 "Ancho" => 1585 "Tamanyo" => 490708 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histology image (hematoxylin-eosin, original magnification, ×40) of a subcorneal pustule filled with polymorphonuclear leukocytes showing epidermal exocytosis.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Noninfectious Diseases</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Miliaria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span 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bullosa \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Urticaria pigmentosa \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Incontinentia pigmenti \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Infectious Diseases</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Congenital candidiasis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Impetigo \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Scabies \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Scalded skin syndrome \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Herpes \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183218.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Principal Differential Diagnosis of Vesicular Pustules in Neonates.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vesiculopustular eruptions in Down syndrome neonates with myeloproliferative disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Nijhawan" 1 => "E. Baselga" 2 => "A. Gonzalez-Ensenat" 3 => "A. Vicente" 4 => "J.F. Southern" 5 => "B.M. Camitta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2001" "volumen" => "137" "paginaInicial" => "760" "paginaFinal" => "763" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11405767" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Síndrome mieloproliferativo transitorio neonatal y otras anomalías hematológicas en síndrome de Down" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Avellón" 1 => "C. Mata" 2 => "M. Echeverría" 3 => "M.I. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 81 | 47 | 128 |
| 2024 September | 92 | 28 | 120 |
| 2024 August | 112 | 82 | 194 |
| 2024 July | 94 | 30 | 124 |
| 2024 June | 99 | 38 | 137 |
| 2024 May | 75 | 37 | 112 |
| 2024 April | 74 | 17 | 91 |
| 2024 March | 90 | 35 | 125 |
| 2024 February | 76 | 28 | 104 |
| 2024 January | 76 | 36 | 112 |
| 2023 December | 63 | 15 | 78 |
| 2023 November | 66 | 24 | 90 |
| 2023 October | 76 | 24 | 100 |
| 2023 September | 78 | 32 | 110 |
| 2023 August | 48 | 18 | 66 |
| 2023 July | 86 | 32 | 118 |
| 2023 June | 64 | 22 | 86 |
| 2023 May | 85 | 28 | 113 |
| 2023 April | 73 | 19 | 92 |
| 2023 March | 77 | 25 | 102 |
| 2023 February | 58 | 17 | 75 |
| 2023 January | 62 | 32 | 94 |
| 2022 December | 70 | 31 | 101 |
| 2022 November | 36 | 36 | 72 |
| 2022 October | 28 | 27 | 55 |
| 2022 September | 32 | 50 | 82 |
| 2022 August | 28 | 38 | 66 |
| 2022 July | 27 | 31 | 58 |
| 2022 June | 36 | 30 | 66 |
| 2022 May | 94 | 45 | 139 |
| 2022 April | 81 | 38 | 119 |
| 2022 March | 108 | 50 | 158 |
| 2022 February | 67 | 23 | 90 |
| 2022 January | 48 | 39 | 87 |
| 2021 December | 48 | 39 | 87 |
| 2021 November | 50 | 42 | 92 |
| 2021 October | 69 | 59 | 128 |
| 2021 September | 40 | 35 | 75 |
| 2021 August | 48 | 31 | 79 |
| 2021 July | 29 | 25 | 54 |
| 2021 June | 45 | 28 | 73 |
| 2021 May | 38 | 43 | 81 |
| 2021 April | 89 | 71 | 160 |
| 2021 March | 100 | 35 | 135 |
| 2021 February | 85 | 18 | 103 |
| 2021 January | 41 | 22 | 63 |
| 2020 December | 49 | 11 | 60 |
| 2020 November | 23 | 22 | 45 |
| 2020 October | 22 | 18 | 40 |
| 2020 September | 34 | 8 | 42 |
| 2020 August | 27 | 18 | 45 |
| 2020 July | 29 | 20 | 49 |
| 2020 June | 50 | 23 | 73 |
| 2020 May | 29 | 16 | 45 |
| 2020 April | 53 | 22 | 75 |
| 2020 March | 44 | 18 | 62 |
| 2020 February | 5 | 0 | 5 |
| 2020 January | 4 | 1 | 5 |
| 2019 December | 8 | 3 | 11 |
| 2019 November | 4 | 1 | 5 |
| 2019 October | 0 | 2 | 2 |
| 2019 September | 10 | 4 | 14 |
| 2019 August | 4 | 0 | 4 |
| 2019 July | 2 | 0 | 2 |
| 2019 June | 4 | 12 | 16 |
| 2019 May | 3 | 46 | 49 |
| 2019 April | 0 | 21 | 21 |
| 2019 March | 0 | 10 | 10 |
| 2019 February | 2 | 3 | 5 |
| 2019 January | 1 | 1 | 2 |
| 2018 December | 2 | 5 | 7 |
| 2018 November | 1 | 0 | 1 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 6 | 0 | 6 |
| 2018 March | 0 | 1 | 1 |
| 2018 February | 52 | 4 | 56 |
| 2018 January | 51 | 5 | 56 |
| 2017 December | 62 | 10 | 72 |
| 2017 November | 47 | 6 | 53 |
| 2017 October | 42 | 2 | 44 |
| 2017 September | 37 | 4 | 41 |
| 2017 August | 46 | 8 | 54 |
| 2017 July | 35 | 8 | 43 |
| 2017 June | 45 | 11 | 56 |
| 2017 May | 36 | 4 | 40 |
| 2017 April | 31 | 5 | 36 |
| 2017 March | 25 | 7 | 32 |
| 2017 February | 43 | 4 | 47 |
| 2017 January | 45 | 5 | 50 |
| 2016 December | 60 | 11 | 71 |
| 2016 November | 78 | 12 | 90 |
| 2016 October | 110 | 12 | 122 |
| 2016 September | 174 | 9 | 183 |
| 2016 August | 74 | 4 | 78 |
| 2016 July | 44 | 7 | 51 |
| 2016 June | 4 | 8 | 12 |
| 2016 May | 7 | 9 | 16 |
| 2016 April | 8 | 1 | 9 |
| 2016 March | 4 | 7 | 11 |
| 2016 February | 5 | 1 | 6 |
| 2016 January | 5 | 1 | 6 |
| 2015 December | 8 | 7 | 15 |
| 2015 November | 26 | 7 | 33 |
| 2015 October | 31 | 1 | 32 |
| 2015 September | 9 | 6 | 15 |
| 2015 August | 14 | 2 | 16 |
| 2015 July | 128 | 16 | 144 |
| 2015 June | 94 | 11 | 105 |
| 2015 May | 117 | 21 | 138 |
| 2015 April | 88 | 16 | 104 |
| 2015 March | 98 | 18 | 116 |
| 2015 February | 101 | 17 | 118 |
| 2015 January | 73 | 13 | 86 |
| 2014 December | 54 | 6 | 60 |
| 2014 November | 55 | 10 | 65 |
| 2014 October | 68 | 6 | 74 |
| 2014 September | 49 | 8 | 57 |
| 2014 August | 53 | 7 | 60 |
| 2014 July | 56 | 6 | 62 |
| 2014 June | 105 | 10 | 115 |
| 2014 May | 79 | 6 | 85 |
| 2014 April | 57 | 5 | 62 |
| 2014 March | 52 | 10 | 62 |
| 2014 February | 49 | 5 | 54 |
| 2014 January | 41 | 6 | 47 |
| 2013 December | 51 | 9 | 60 |
| 2013 November | 29 | 10 | 39 |
| 2013 October | 30 | 6 | 36 |
| 2013 September | 44 | 6 | 50 |
| 2013 August | 33 | 22 | 55 |
| 2013 July | 22 | 21 | 43 |
| 2013 June | 7 | 15 | 22 |
| 2013 May | 5 | 21 | 26 |
| 2013 April | 10 | 25 | 35 |
| 2013 March | 7 | 15 | 22 |
| 2013 February | 5 | 3 | 8 |
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