Chloramphenicol投与後広汎な骨髄壊死を呈した非白血病性白血病の1例

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A 50 year-old man was admitted to our clinic because of abrupt severe headache and vomitting. The diagnosis of subdural hemorrhage was made. Results of examination on admission, : hemoglobin concentration 14.5gr per 100 ml, red blood count (RBC) 5, 410, 000, white blood count (WBC) 5, 100, platelet count 194, 790. Another laboratory studies were not remarkable except that occult blood test was positive in feces. He had past history of hemorrhoid. Hemorrhages in the skin and mucous menbranes were absent. From the second days after admission, the patient was treated with chloramphenicol (CP) Igr daily for nineteen days because of fever. The patient improved gradually and could walk alone. Twenty-six days after admission, he had fever again, and then RBC (3, 010, 000) and WBC (1, 900) showed the striking decrement comparing with these on admission. At that time, the myelogram demostrated that myeloblasts were 21.8% and lymphocytes were 62%. The nucleated cells was 19, 000. In spite of being treated with adreno-corticosteroid hormones and blood tranf usions, platelet (5, 500) and WBC (1, 300) decreased markedly. Explosively, hemorrhagic manifestations were aggravated and the patient died. The autopay performed. Aleukemic-leukemia was made in view of the pathologic findings of widespread necrosis of bone marrow and immature leukocytes in the various organs. But, there were no immature leukocytes in the organs of hemorrhages. In the present case, we suggest that the onset of leukemia might be caused by CP.
学校法人昭和大学・昭和医学会の論文

Chloramphenicol投与後広汎な骨髄壊死を呈した非白血病性白血病の1例

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