Paper # 095 | Versión en Español |
Andréa Rodrigues Cordovil Pires, Luciana Wernersbach Pinto.
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We report a case of a 54 years-old white woman that, in august 1996 came to our hospital complainig of sore throat, fever with chills and neck enlargement after contact with her grandson with the same symptoms three days before. She was using symptomatic non steroidal antiinflamatory drugs. She was also taking sulphona for three months to treat tuberculoid leprosy diagnosed by a skin biopsy. She had a myocardial infarct three years ago, with subsequent sporadic use of vasodilators. She was a light smoker (two to four cigarrettes per day) and worked in a plastic factory from 30 to 34 years-old. At hospital admission she was toxemic, with large bilateral supurative cervical lymphadenopathy and white plaques and pustules in palate. Her physical examination showed high axilary temperature (38,7 °C), normal arterial pressure (100 x 70 mmHg), tachypnea ((40 per minute), tachycardia (120 beats per minute) and moderate hepatosplenomegaly. The ECG confirmed the diafragmatic myocardial infact. Hemograms showed severe pancytopenia, with global leucocyte count of 300 cell/mm3 (100% lymphocytes), 21% hematocrit, 90.000 platelets/mm3 and anisopoikilocytosis with elongated and teardrop erithrocytes. She received antibiotics. The diagnosis of agnogenic myeloid metaplasia was made after a bone marrow in the tenth day of hospitalization and she received granulocyte colony-stimulating factor (G-CSF). After more ten days she had a severe respiratory insuficiency due to pulmonary infection and died. Her body was submitted to autopsy.