A Case of Acute Myeloid Leukemia Developing after Treatment for Brucellosis with Pancytopenia

Sun Hyung Kim; Kyung Pyo Kim; Sanghoon Han; Young Ree Kim; Sung Ha Kang

doi:10.3343/lmo.2015.5.3.157

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Kim, Kim, Han, Kim, and Kang: A Case of Acute Myeloid Leukemia Developing after Treatment for Brucellosis with Pancytopenia

Case Report

Diagnostic Hematology

Laboratory Medicine Online 2015; 5(3): 157-160.

Published online: 1 July 2015

DOI: https://doi.org/10.3343/lmo.2015.5.3.157

A Case of Acute Myeloid Leukemia Developing after Treatment for Brucellosis with Pancytopenia

Sun Hyung Kim, M.D.¹, Kyung Pyo Kim, ², Sanghoon Han, M.D.³, Young Ree Kim, M.D.¹, Sung Ha Kang, M.D.¹

¹Department of Laboratory Medicine, Jeju National University School of Medicine, Jeju, Korea.

²Jeju National University School of Medicine, Jeju, Korea.

³Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

Corresponding author: Young Ree Kim. Department of Laboratory Medicine, Jeju National University School of Medicine and Jeju National University Hospital, 15 Aran 13-gil, Jeju 690-767, Korea. Tel: +82-64-717-1454, Fax: +82-64-717-1457, namu8790@jejunu.ac.kr

Received 13 August 2014 Revised 31 October 2014 Accepted 25 November 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Human brucellosis is an important zoonotic disease and has a wide clinical spectrum. Nonspecific hematologic abnormalities related to brucellosis are frequently found, but pancytopenia is uncommon. Malignant diseases have been infrequently reported as a rare cause of pancytopenia in patients with brucellosis. We describe a patient with brucellosis and pancytopenia who was later diagnosed with acute myeloid leukemia. A 71-yr-old man was admitted to a hospital with fever and pancytopenia. Brucella was cultured from blood, and the bone marrow findings were in accordance with brucellosis. The patient's clinical symptoms improved; however, he still showed pancytopenia after completion of medical treatment. After approximately 6 months, he was readmitted with pneumonia and pancytopenia. The second bone marrow examination revealed hypercellular marrow with increased number of blasts. The chromosome analysis showed 46,XY,trp(8)(q11.2q22)[8]/46,idem,del(7)(q22)[12]. The patient was diagnosed with acute myeloid leukemia with myelodysplasia-related changes. He refused further evaluation and therapy, and subsequently died while receiving conservative treatment.

Keywords: Brucellosis, Pancytopenia, Acute leukemia

Figures and Tables

Fig. 1

Results of the first bone marrow examination. (A) Biopsy showing hypercellular marrow with megakaryocytic hyperplasia (Hematoxylin & Eosin staining, ×200). (B) An aspirate smear showing erythroid hyperplasia (Wright staining, ×1,000).

Fig. 2

Results of the second bone marrow examination. (A) An aspirate smear showing increased number of blasts and dyserythropoiesis (arrow) (Wright staining, ×1,000). (B) An aspirate smear showing increased number of blasts and dysgranulopoiesis (arrow) (Wright staining, ×1,000).

Notes

This article is available from http://www.labmedonline.org

This research was supported by the 2015 Scientific Promotion Program funded by Jeju National University.

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