Blast Crisis associated with Episodic Febrile Attacks in a Patient with Chronic Lymphatic Leukemia
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概要
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A seventy-five year-old female with 17 years' clinical history of chronic lymphatic leukemia was described. An immunologic analysis revealed that leukemic lymphocytes of the patient have surface markers cosisting of μ-chain positive cells 88%, δ-chain positive cells 3% and γ-chain cells 1%. As to light chain of surface Ig, κ-chain positive cell 7% and λ-chain cells of 85% out of 100 lymphocytes were recorded. Acid phosphatase staining showed 95% positive in lymphocytes, and non-specific esterase staining revealed 51% positive in lymphocytes, without any combination chemotherapies when examined. She was then well controlled only with low-dose cyclophosphamide 20 mg〜50 mg a day, for the intitial 15 years' stable course. She developed a blast crisis of CLL at the last stage of her clinical course. It is interesting that a febrile episode over 38℃ was noted for a few days, followed by an abrupt increase of Lymphoblasts in the peripheral blood of short duration. This type of combined episodes of fever and lymphoblastosis subsided for a while, but the similar phenomenon was repeatedly seen in the subsequent course of her illness. She eventually died of chronic heart failure. On autopsy, the diagnosis of CLL blast crisis was confirmed, with pathological findings of infiltrations of lymphocytes, lymphoblasts and some plasma cells in various tissues including the marrow, spleen, liver, adrenals, heart, kidneys, lungs, intestines and lymph nodes. The episodic fever associated blastic crisis discussed.
- 神戸大学の論文
- 1994-12-28
著者
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YAMAGUCHI Nobuo
Department of Fundamental Research for Complementary and Alternative Medicine, Kanazawa Medical Univ
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Chihara Kazuo
Kobe University Graduate School of Medicine
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Chihara K
Division Of Diabetes Metabolism And Endocrinology Department Of Internal Medicine Kobe University Gr
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Chihara Kazuo
The Third Division Department Of Medicine Kobe University School Of Medicine
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Yamada Hajime
The Third Department Of Medicine Kobe University School Of Medicine
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Isobe Takashi
Kobe University
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Shiozawa Shunichi
Faculty of Health Sciences, Kobe University School of Medicine
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Isobe Takashi
Faculty of Health Science, Kobe University
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Isikawa Hitoshi
Faculty of Health Science, Kobe University
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Mituda Tokuji
Department of Central Laboratory, Kobe University Hospital
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Sakada Hiroyuki
Department of Central Laboratory, Kobe University Hospital
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Aotani Yukie
Department of Central Laboratory, Kobe University Hospital
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Tada Kazuo
The Third Division, Department of Medicine, Kobe, University School of Medicine
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Morishita Tomiyuki
The Third Division, Department of Medicine, Kobe, University School of Medicine
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Shiozawa Shunichi
The Third Division, Department of Medicine, Kobe, University School of Medicine
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Tada Kazuo
The Third Division Department Of Medicine Kobe University School Of Medicine
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Aotani Yukie
Department Of Central Laboratory Kobe University Hospital
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Isobe Takashi
Faculty Of Health Science Kobe University School Of Medicine
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Mituda Tokuji
Department Of Central Laboratory Kobe University Hospital
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Shiozawa Shun-ichi
The Third Division Department Of Medicine Kobe University School Of Medicine
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Isikawa Hitoshi
Faculty Of Health Science Kobe University
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Sakada Hiroyuki
Department Of Central Laboratory Kobe University Hospital
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Morishita Tomiyuki
The Third Division Department Of Medicine Kobe University School Of Medicine
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Yamaguchi Nobuo
Department Of Central Laboratory Kobe University Hospital
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Yamaguchi Nobuo
Department Of Applied Chemistry Muroran Institute Of Technology
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Isobe Takashi
Faculty Of Health Science Kobe University
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CHIHARA KAZUO
The Third Department of Internal Medicine, Kobe University School of Medicine
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