脾結核に続発したと思われる骨髄線維症の1例

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タイトル別名
  • Myelofibrosis Probably Secondary to Splenic Tuberculosis: Report of a Case
  • ヒ ケッカク ニ ゾクハツシタ ト オモワレル コツズイ センイショウ ノ 1

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The patient, a 62 year old housewife, was referred here from a certain clinic because of the chief complaint of hepatosplenomegaly. Hematologic examination revealed a moderate degree of anemia with associated leukoerythroblastosis and increased WBC. The neutrophils showed a high alkaline phosphatase score and no abnormal (Ph1) chromosome was demonstrable in the peripheral blood cells or bone marrow cells; hence distinguishable from chronic myelogenous leukemia (CML). The patient's peripheral blood showed normal ferrokinetics and a notably shortened red cell life span. The Mantoux test was negative and there existed no abnormal finding as to the blood coagulation and fibrinolytic systems whereas the platelet adhesiveness was noted to be reduced. Bone marrow biopsy disclosed a marked degree of fibrosis and there was evidence of conspicuous extramedullary hematopoiesis in the liver; the case was diagnosed as primary myelofibrosis. The patient was admitted to this hospital for splenectomy since she had failed to respond to prednisolone therapy with any significant amelioration in anemia at the clinic and because of progressively increasing splenomegaly with development of pain. There were abscesses in the spleen and the patient was diagnosed microscopically as splenic tuberculosis. Extramedullary hematopoiesis was also prominent in the spleen. After the operation, serum hepatitis and pneumonia developed and she died of these conditions and incomplete suturation.<br>While there has been no reported case of “myelofibrosis secondary to tuberculosis” in Japan, a total of 252 cases of myelofibrosis were reported during the period from 1940 to 1975 and as many as 28 cases (11.1%) among them had a complication or a history of tuberculosis. Importance of the study of myelofibrosis in closer connection with tuberculosis has been emphasized.

収録刊行物

  • 臨床血液

    臨床血液 17 (12), 1283-1288, 1976

    一般社団法人 日本血液学会

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