Hypoplastic Leukemiaと鑑別困難な血液所見を示した全身性粟粒結核症の1例

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書誌事項

タイトル別名
  • A Case of Miliary Tuberculosis Presenting Blood Pictures Similar to That of So-called Hypoplastic Leukemia
  • Hypoplastic Leukemia ト カンベツ コンナン ナ ケツエキ

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抄録

A 66-year-old female is presented who had peripheral blood and bone marrow pictures similar to so-called hypoplastic leukemia throughout her course of illness, but autopsy disclosed leukemoid reaction secondary to generalized miliary tuberculosis.<br>She was admitted on Feb. 5, because of pallor. Peripheral blood studies on admission revealed RBC 1.76×106/μl, Hb 4.1 g/dl, Ht 13%, reticulocyte 0.1%, platelet 20×103/μl, and WBC 2,800/μl with about 6.5% blast cells, which were identified as myeloblasts. Bone marrow aspiration revealed hypocellularity with 34.4% blasts similar to those in the peripheral blood. Although the percentage of myeloblasts both in the blood and marrow were decreased shortly after treatment with repeated blood transfusions and corticosteroids, her general condition gradually deteriorated and she died 3 months after admission. Postmortem examination revealed no evidence of leukemic infiltration, while many organs were severely invaded by tuberculous bacilli.<br>It was strongly suggested that a diagnosis of hypoplastic leukemia should be made only after excluding possible underlying disorders which might induce leukemoid reaction with bone marrow hypoplasia. On this point of view, a comparison was made between the blood pictures obtained from the present case and 5 cases with hypoplastic leukemia confirmed by autopsy. As the results, patients presenting 1) microcytic, hypochromic anemia associated with markedly reduced reticulocyte counts, 2) reduction of myeloblasts after corticosteroid therapy, 3) marked erythroid hypoplasia in the bone marrow and 4) lack of relative lymphocytosis in the blood and marrow might be much more likely to be associated with leukemoid reaction than with real hypoplastic leukemia.

収録刊行物

  • 臨床血液

    臨床血液 18 (11), 1328-1335, 1977

    一般社団法人 日本血液学会

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