Promyelocytic Leukaemoid Reaction: An Atypical Presentation of Mycobacterial Infection

Abstract

A young woman presented with mild pyrexia and antepartal haemorrhage due to disseminated intravascular coagulation. She had pancytopenia in the peripheral blood and granulocytic maturation arrest at the promyelocyte stage in the bone marrow. Her urine and bone marrow grew Mycobacterium kansasii on culture. Antituberculous treatment eliminated the infection and restored the normality of bone marrow and peripheral blood.

CD66c antigen expression is myeloid restricted in normal bone marrow but is a common feature of CD10+ early‐B‐cell malignancies

“…A support for the expression of leukocyte antigens on normal promyelocytes derives from the study of PLR, a clinical condition secondary either to infectioudinflammatory disease or to toxic drugs, characterized by acute agranulocytosis with marked increase of reactive promyelocytes in the bone marrow (28)(29)(30). The immunophenotype greatly contributes to distinguish these cases from APL, since CDlla, CDllb, CD24, CD45RO and CD66b, usually present on normal promyelocytes, are absent on the surface of APL blast cells (30).…”

Pancytopenia with Hypocellular Bone Marrow due to Miliary Tuberculosis: An Unusual Presentation

“…Peritoneoscopy was performed to evaluate ascites; in the liver biopsy specimen caseous gra nulomas were seen and the patient was found to suffer from miliary tubercu losis. Antituberculous therapy was begun and the patient recovered completely and the haematological parameters returned to normal.Miliary tuberculosis (MTB) may present with protean haematologic manifestations including monocytosis, leukaemoid reaction, leukopenia, anaemia, basophilia, dis seminated intravascular coagulation and rarely pancyto penia [1][2][3]. Pancytopenia with hypoplastic bone marrow is extremely rare and there is still much controversy whether it is a complication of MTB or vice versa [4].…”