Lab Med Online.  2015 Jul;5(3):157-160. 10.3343/lmo.2015.5.3.157.

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

• Kim SH
• Kim KP
• Han S
• Kim YR
• Kang SH

• KMID: 1821784
• DOI: http://doi.org/10.3343/lmo.2015.5.3.157

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.

Keyword

Brucellosis; Pancytopenia; Acute leukemia

MeSH Terms

Bone Marrow
Bone Marrow Examination
Brucella
Brucellosis*
Fever
Humans
Leukemia, Myeloid, Acute*
Pancytopenia*
Pneumonia
Zoonoses

Figure

• 

  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).

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