Plasma cell leukemia, Pseudomonas aeruginosa infection
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2016, Vol 33, Issue 2
Abstract
A 68-year-old woman was admitted to the hospital because of 6 month history of bone pain located in lumbar area and aggravated by movement, as well as fatigue. The non-steroidal anti-inflammatory drugs (NSAIDs) administration had no effect. The patient also presented progressive weakness and mild dyspnea on exertion. She, occasionally, was feeling dizzy and experienced visual disturbances. One week before admission she had an episode of nosebleeding. Her past medical history was unremarkable. On examination, she appeared pale. The temperature was 38.8 oC, the pulse was 110/min and the blood pressure was 11/70 mmHg. The liver was non-tender, and palpable 2 cm below the right costal margin. The spleen was not palpable. Pressure on the lumbosacral vertebrae worsened the pain, which had radicular features. Her hematological tests revealed a normocytic normochromic anemia (Ht: 26.9%, Hb: 8.5 g/dL, with 0.1% reticulocytes, a mild leukopenia (WBC 3.100/μL, neutrophils 19%, lymphocytes 42%, monocytes 9%, metamyelocytes 4%, and atypical blast cells 24% (figures 1 to 5) and platelets 40.000/mL. The erythrocyte sedimentation rate was 125 mm/1 hour. Coagulation studies were normal. Her biochemical tests were: BUN 75 mg/dL, creatinine 2.6 mg/dL, SGOT 19 IU/L, SGPT 21 IU/L, LDH 1,110 IU/L, ALP 135 IU/L, γ-GT 29 IU/L, Na+ 141 Meq/L, K+ 4.7 Meq/L, Ca++ 6.3 mg/dL, and serum total proteins 10.9 g/dL (albumin 4 g/dL, globulins 6.9 g/dL). The serum protein electrophoresis revealed a spike in the area of γ-globulins. The bone marrow aspirate was diagnostic (fig. 6). On the second day of hospitalization, the patient’s condition worsened. The temperature rose up to 39.4 oC, and she presented a mild pain in the right arm and thigh
Authors and Affiliations
J. ASIMAKOPOULOS, L. PAPAGEORGIOU, V. TELONIS, A. ZANNOU, P. ARAPAKI, T. GIANNIKOS, G. DRYLLIS, I. KONSTANTIKOU, G. GAINAROU, E. SINNI, M. ANGELOP{OULOU, K. KONSTANTOPOULOS
Keywords
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