Ajimaline-Induced Plasmacytosis with Pancytopenia

Abstract

It was obsereved a remarkable plasmacytosis in bone marrow of a patient with agranulocytosis due to antiarrythmia drug, ajimaline. A 48-year-old woman was admitted because of high fever, periproctal abscess and pharyngitis. Before the onset of these symptoms, she had been treated with ajimaline for 3 months. On admission, her WBC count was 700/cmm, with 5% plasma cells and 90% lymphocytes; hemoglobin 9.5g/dl ; and platelet count 3.0×10⁴/cmm. Bone marrow revealed a slight hypocellularity and 77.2% of the nucleated cells were plasma cells, some of which appeared immature and dysplastic. Serum protein electrophoresis showed polyclonal hypergammaglobulinemia. Urine was negative for Bence Jones protein. After the beginning of methylprednisolone, she had rapidly improved and the recovery of marrow function was noted by the 5th hospital day. On day 12, bone marrow was normocellular with myeloid hyperplasia. Morphologically normal plasma cells now made up only 1% of the cellular element of the marrow.