熱帯熱マラリアによる類白血病反応の一例

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概要

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• A 31 year old man was admitted on June 23, 1970, complaining of irregular high fever with vomitting, marked headache and myalgia in paroxysms, and profound weakness. He had returned to Tokyo from Europe on May 14, 1970. On his way, he stayed for a week in some region of Africa and the above symptoms developed on 5th day after his arrival in Japan.On admission, he was pale with slight jaundice. Liver and spleen were palpable two fingerbreadths below the costal margin. His blood examination showed marked normochromic anemia and leukopenia (WBC 2800/mm3) with increased neutrophilic series and a few atypical immature cells. The first examination of his sternal bone marrow showed a slight increase in the primitive cells of myelogenous series although the blast cells were 5.0%, in which were found some atypical cell in nature.By these findings, he was suggested to be in the early stage of AML, such as preleukemic acute human leukemia, even though there was a lack of typical signs of AML.Therefore he was treated with some anti-leukemic agents for only 3 days., and suddenly many Plasmodium falciparum were detected from blood smear obtained on June 26. On June 29, anti-malaria treatment was started with chloroquine diphosphate and soon after he was greatly improved. In previous bone marrow and blood smears which were re-examined after correct diagnosis had been made, only a few malaria plasmodium could be found.Until now, no such cases of malaria which showed a leukemic blood picture have been reported in Japan. Because of the rarity of leukemoid reaction caused by falciparum malaria, this case was reported.

• 一般社団法人 日本血液学会の論文

一般社団法人 日本血液学会 | 論文

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