Chlorpromazine and thioridazine are phenothiazines employed in the treatment of psychosis. These agents inhibited the respiration of clinical isolates of Mycobacterium tuberculosis resistant to streptomycin, rifampin, isoniazid, ethambutol and/or pyrazinamid, all first line drugs. Since any adverse reaction to thioridazine is generally less severe than to chlorpromazine, the possibility is attractive that thioridazine may have a potential in the initial management of patients with newly diagnosed tuberculosis with an as yet undetermined antibiotic susceptibility profile.
We report a 55-year-old male with a diagnosis of intravascular lymphoma and hemophagocytosis. He initially presented with hemolytic anemia and splenomegaly and was successfully treated with oral steroids. His clinical course was later complicated by fever, cytopenias, hypoalbuminemia, disseminated intravascular coagulation, gastrointestinal bleeding and acute tubular necrosis. Results of an extensive investigation for fever of unknown origin were negative. Although the patient was treated aggressively with antimicrobials, transfusion support and dialysis, he expired 3 weeks after hospitalization. Post-mortem analysis revealed large CD30- and CD45-positive lymphoma cells in an intravascular distribution in most of the organs studied. Histopathology of the spleen and bone marrow was significant for fulminant hemophagocytosis.
Chronic lymphocytic leukemia (CLL) is rarely associated with Hodgkin's disease (HD).We report a case of nodular sclerosis HD in a patient previously diagnosed with CLL.
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