A Case of Acute Promyelocytic Leukemia with Remarkable Elevation of Serum LDH and Multiple Bone Marrow Necroses at Autopsy

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  • IWATA Junichi
    The First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • TANABE Akira
    The First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • MIYAKE Kazuhiko
    The First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • KAMAKURA Masahide
    The First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • OHASHI Tatsuya
    The First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • ODA Toshitsugu
    The First Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • TANGE Tsuyoshi
    Department of Pathology, Faculty of Medicine, University of Tokyo
  • OIKAWA Tatsuro
    Department of Internal Medicine, Ohmori Red-Cross Hospital

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Other Title
  • 血清LDHが異常高値を示し，剖検で骨髄の多発性壊死を認めた急性前骨髄球性白血病の1例
  • ケッセイ LDH ガ イジョウ タカネ オ シメシ ボウケン デ コツズイ ノ

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Abstract

A 47-year old man was admitted to the Ohmori Red-Cross Hospital because of recurrent high fever associated with systemic bone and joint pain on September 25, 1978.<br>On admission, hematologic examination showed no anemia nor thrombocytopenia and moderate leukocytosis with appearance of immature granulocytes and erythroblasts in a low percentage.<br>Recurrent bone narrow aspiration was all dry tap. At the beginning of October, pancytopenia developed rapidly with transient remarkable elevation of serum LDH activity up to 26,000 IU/ml, and serum uric acid 27 mg/dl, previous to the initiation of antileukemic chemotherapy.<br>He died of sepsis on October 18. Autopsy showed diffuse proliferation of promyelocytes in the bone marrow and a diagnosis of acute promyelocytic leukemia was established.<br>Multiple bone marrow necroses were seen in the vertabrae, costae, sternum and iliac bone. The remarkalde elevation of serum LDH and uric acid in this case is attributed to the necrosis of leukemic cells in the bone marrow.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 21 (11), 1802-1807, 1980

    The Japanese Society of Hematology

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