Abstract
A 70-year-old woman with myelodysplastic syndrome (MDS) had been followed for 10 years； the woman had refractory cytopenia with multilineage dysplasia and ring sideroblasts (RCMD)） and had been diagnosed as having intermediate-risk (Int 1) MDS according to the International Prognostic Scoring System (IPSS). On February 11, 2012, the woman was seen for right lower abdominal pain, and was diagnosed as having gangrenous appendicitis. The platelet count was decreased to 1.4×104/μL, therefore, conservative treatment was selected. She was kept nil by mouth and treated with meropenem 1.5 g/day. This resulted in alleviation of her symptoms, and the patient was discharged after 10 days of hospitalization. Three months later, the patient was transfused with platelets, and a laparoscopic appendectomy was performed. Pathology revealed appendicitis catarrhalis. Interval appendectomy allows preparation time for platelet transfusion, and was found to be a suitable approach to treat acute appendicitis in our patient with MDS with a marked decrease of the platelet count.
