Abstract
A 54 year-old man was admitted to the Toho university hospital because of general malaise in May 1976. On admission he had anemia, slight icterus and hepatosplenomegaly. Laboratory findings revealed severe anemia, thrombocytosis and reticulocytosis.
The leukocyte count was 10,000/mm3 with 12% myeloblasts, 0.5% promyelocytes, 2.0% myelocytes, 0.5% metamyelocytes, 6.0% band forms, 38.0% segmented neutrophils, 2.5% eosinophils, 15.5% basophils, 1.0% monocytes and 22.0% lymphocytes. Circulating nucleated red cells were also seen.
A bone marrow aspiration showed normocellularity but it revealed outstanding erythroid hyperplasia with atypical and megaloblastoid forms.
He was treated with prednisolone but on February 8 1977, hemoglobinemia occurred in him. A sugar water test, Ham test and Crosby test were all positive. In April 1977, he died of lung tuberculosis after 7 months from admission.
For this case, PNH occured during the course of erythroleukemia. This complication is rare but according to Dameshek, PNH is supposed to be a variant form of myeloproliferative disorders.
This was an interesting case in point of pathogenetic relationship between PNH and erythroleukemia.
