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Transient Histiocytosis With Striking Phagocytosis of Platelets, Leukocytes, and Erythrocytes

Transient Histiocytosis With Striking Phagocytosis of Platelets, Leukocytes, and Erythrocytes Abstract The term "histiocytic medullary reticulosis" first was introduced by Scott and Robb-Smith1 to describe a disorder of the reticuloendothelial system characterized by fever, hepatosplenomegaly, progressive anemia, leukopenia, thrombocytopenia, and, usually, a fatal outcome. Morphologically, there is a neoplastic proliferation of histiocytes in the medullary portions of lymph nodes, intense erythrophagocytosis, and varying degrees of leukophagocytosis and thrombophagocytosis. Nearly 100 case reports of this disorder have been published to date.2-13 This report describes the cases of two patients who had many of the classic signs and symptoms of this disease, including erythrophagocytosis, leukophagocytosis, and thrombophagocytosis, that were completely reversible. These findings were associated with a viral-like illness in one patient and miliary tuberculosis in the second patient. Both patients are alive and well four years and two years later, respectively, and are totally asymptomatic. PATIENT SUMMARIES Patient 1. —A 19-year-old man was hospitalized because of fever and muscle aches References 1. Scott RB, Robb-Smith AHT: Histiocytic medullary reticulosis. Lancet 2:194-198, 1939.Crossref 2. Greenberg E, Cohen DM, Pease GL, et al: Histiocytic medullary reticulosis. Proc Mayo Clin 37:271-283, 1962. 3. Zak FG, Rubin E: Histiocytic medullary reticulosis. Am J Med 31:813-819,1961.Crossref 4. Boake WC, Card WH, Kimmey JF: Histiocytic medullary reticulosis: Concurrence in father and son. Arch Intern Med 116:245-252, 1965.Crossref 5. Friedman RM, Steigbigel NH: Histiocytic medullary reticulosis. Am J Med 38:130-133, 1965.Crossref 6. Lynch EC, Alfrey CP Jr: Histiocytic medullary reticulosis: Hemolytic anemia due to erythrophagocytosis by histiocytes. Ann Intern Med 63:666-671, 1965.Crossref 7. Natelson EA, Lynch EC, Hettig RA, et al: Histiocytic medullary reticulosis: The role of phagocytosis in pancytopenia. Arch Intern Med 122:223-229, 1968.Crossref 8. Clark BS, Dawson PJ: Histiocleumedullary reticulosis presenting with leukemic blood picture. Am J Med 47:314-317, 1969.Crossref 9. Abele DC, Griffin TB: Histiocytic medullary reticulosis: Report of two cases and review of literature. Arch Dermatol 106:319-329, 1972.Crossref 10. Seligman BR, Rosner F, Lee SL, et al: Histiocytic medullary reticulosis: Fatal hemorrhage due to massive platelet phagocytosis. Arch Intern Med 129:109-113,1972.Crossref 11. Asher R: Histiocytic medullary reticulosis: A case without lymphadenopathy. Lancet 1:650-651, 1946.Crossref 12. Hirsh J, Unger B, King WE, et al: Histiocytic medullary reticulosis: A case report. Aust Ann Med 13:269-274, 1964. 13. Serck-Haussen A, Purchit GP: Histiocytic medullary reticulosis: Report of 14 cases from Uganda. Br J Cancer 22:506-516, 1968.Crossref 14. Dameshek W, Schwartz SO: Acute hemolytic anemia. Medicine 19:231-237, 1940.Crossref 15. Wilcox DRC: Hemolytic anemia and reticulosis. Br Med J 1:1322-1325, 1952.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Transient Histiocytosis With Striking Phagocytosis of Platelets, Leukocytes, and Erythrocytes

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1975.00330070111019
Publisher site
See Article on Publisher Site

Abstract

Abstract The term "histiocytic medullary reticulosis" first was introduced by Scott and Robb-Smith1 to describe a disorder of the reticuloendothelial system characterized by fever, hepatosplenomegaly, progressive anemia, leukopenia, thrombocytopenia, and, usually, a fatal outcome. Morphologically, there is a neoplastic proliferation of histiocytes in the medullary portions of lymph nodes, intense erythrophagocytosis, and varying degrees of leukophagocytosis and thrombophagocytosis. Nearly 100 case reports of this disorder have been published to date.2-13 This report describes the cases of two patients who had many of the classic signs and symptoms of this disease, including erythrophagocytosis, leukophagocytosis, and thrombophagocytosis, that were completely reversible. These findings were associated with a viral-like illness in one patient and miliary tuberculosis in the second patient. Both patients are alive and well four years and two years later, respectively, and are totally asymptomatic. PATIENT SUMMARIES Patient 1. —A 19-year-old man was hospitalized because of fever and muscle aches References 1. Scott RB, Robb-Smith AHT: Histiocytic medullary reticulosis. Lancet 2:194-198, 1939.Crossref 2. Greenberg E, Cohen DM, Pease GL, et al: Histiocytic medullary reticulosis. Proc Mayo Clin 37:271-283, 1962. 3. Zak FG, Rubin E: Histiocytic medullary reticulosis. Am J Med 31:813-819,1961.Crossref 4. Boake WC, Card WH, Kimmey JF: Histiocytic medullary reticulosis: Concurrence in father and son. Arch Intern Med 116:245-252, 1965.Crossref 5. Friedman RM, Steigbigel NH: Histiocytic medullary reticulosis. Am J Med 38:130-133, 1965.Crossref 6. Lynch EC, Alfrey CP Jr: Histiocytic medullary reticulosis: Hemolytic anemia due to erythrophagocytosis by histiocytes. Ann Intern Med 63:666-671, 1965.Crossref 7. Natelson EA, Lynch EC, Hettig RA, et al: Histiocytic medullary reticulosis: The role of phagocytosis in pancytopenia. Arch Intern Med 122:223-229, 1968.Crossref 8. Clark BS, Dawson PJ: Histiocleumedullary reticulosis presenting with leukemic blood picture. Am J Med 47:314-317, 1969.Crossref 9. Abele DC, Griffin TB: Histiocytic medullary reticulosis: Report of two cases and review of literature. Arch Dermatol 106:319-329, 1972.Crossref 10. Seligman BR, Rosner F, Lee SL, et al: Histiocytic medullary reticulosis: Fatal hemorrhage due to massive platelet phagocytosis. Arch Intern Med 129:109-113,1972.Crossref 11. Asher R: Histiocytic medullary reticulosis: A case without lymphadenopathy. Lancet 1:650-651, 1946.Crossref 12. Hirsh J, Unger B, King WE, et al: Histiocytic medullary reticulosis: A case report. Aust Ann Med 13:269-274, 1964. 13. Serck-Haussen A, Purchit GP: Histiocytic medullary reticulosis: Report of 14 cases from Uganda. Br J Cancer 22:506-516, 1968.Crossref 14. Dameshek W, Schwartz SO: Acute hemolytic anemia. Medicine 19:231-237, 1940.Crossref 15. Wilcox DRC: Hemolytic anemia and reticulosis. Br Med J 1:1322-1325, 1952.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1975

References