A 22-year-old girl was admitted to our hospital with complaints of gingival swelling, petechiae on her right thigh and anemia of one month duration. Prior to her admisson she had taken diphenyl-hydantoin sodium (Aleviatin), 500 g in total, for epiletic seisure for 5 years. On admission, physical examination revealed neither hepatosplenomegaly nor lymphadenopathy, but slight anemia, gingival swelling and petechiae.
Haematological study showed normal leukocyte count (6400) with monocytosis (25%) in the peripheral blood and (47%) with a few polynucleated erythroblasts in bone marrow specimen. Histological study of biopsy specimen from the swelled gingival and the ileum, also proved abundance of monocytic series.
All these data told the possibility of monocytic leukemia with nuance of erythroleukemia for this case. One month after her admission, impetigo on her head and face, slight increase in serum-globulin and later hepatomegaly of 2 to 4 finger breadths developed. Corticosteroids and 6MP were given in the last week with out effect. She died of intracerebral bleeding about 11 months after the apearance of gingival swelling.
It seemed very likely that this leukemia, as seen in atomic bombed survivours, might have been possibly invited through unknown mechanism in the course of recovery from the hypoplastic anemia this state was missed in this case.
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