Eosinophilic Leukemia

Abstract

In 1925, I reported the case of a child, aged 6, who showed persistent leukocytosis with extreme eosinophilia and an enlarged spleen.1 At that time I was able to find four other similar cases reported in the literature, all of which, however, had occurred in adults. This symptom\x=req-\ complex has been named by some authors, eosinophilic leukemia, by others, persistent hyperleukocytosis with eosinophilia. Recently I observed another case of this nature in a child, the history of which follows. REPORT OF A CASEHistory.\p=m-\PabloV., a Porto Rican boy, aged 8 years, was admitted to the pediatric service of the Mount Sinai Hospital on Nov. 21, 1929. He had been in the United States one month and had complained for a long time of gastro-intestinal symptoms\p=m-\vomiting and alternating diarrhea and constipation. For many years he had had a chronic, nonproductive cough. His family history was significant in that his mother's first husband had syphilis and one of her four children also had it. The patient had apparently received antisyphilitic treatment several years before.Birth was apparently normal. He was breast-fed for eighteen months. Later in childhood his feeding was irregular, as he had to shift for himself and to pick up whatever food he could get.He was sent to the hospital because he was considered undernourished and because of vague gastro-intestinal symptoms.Examination.-Physical examination revealed a pale, thin boy with a prominent abdomen. His weight on admission was 42 pounds (19.1 Kg.) (the average for his age being 55 pounds [24.9 Kg.]). His height was normal. The following observations were the only ones of significance : There were a few pea-sized, shotty lymph nodes in both axillae and groins. Percussion over the lungs was normal, but on auscultation many coarse rhonchi could be heard over both sides of the chest, most prominently over the base posteriorly. The heart revealed a soft, nontransmitted murmur best heard over the third left interspace. The abdomen was prominent, soft and tympanitic, and no masses could be felt. The liver and spleen could not be felt. The temperature was normal. Urinalysis gave negative results, and the Pirquet test gave a positive reaction.