Paediatrics primary myelofibrosis and acute stroke: A rare presentation

Idiopathic Myelofibrosis is a rare myeloproliferative disorder. In children, it becomes even rarer. Herein, we report a case of idiopathic myelofibrosis of a 6-year old male patient who presented with complaints of pallor, petechiae and bleeding from gums. Bone marrow aspirate showed afragmented haemodiluted smears with erythroid and myeloid precursors scattered throughout. Trephine biopsy showed increased background fibrotic activity along with clusters of histiocytes. A diagnosis of paediatric primary myelofibrosis was made on biopsy. The patient also developed a stroke that resulted in left-sided hemiparesis. An MRI suggested an intraparenchymal haemorrhage along with meningeal extramedullary haematopoiesis.