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FATAL POLYCYTHEMIA FOLLOWING PERNICIOUS ANEMIA TREATED WITH VITAMIN B12*
- CARL F. HINZ, JR., M.D.
- Requests for reprints should be addressed to Carl F. Hinz, Jr., M.D., Western Reserve University School of Medicine, Cleveland 6, Ohio.
Excerpt
INTRODUCTION Since the introduction of specific therapy for pernicious anemia, persons with this disease have lived sufficiently long to develop other disorders of the hematopoietic system. A striking but distinctly unusual instance of this has been the development in such patients of polycythemia vera. Such cases would appear to be interesting in light of the frequent speculation concerning the etiology and pathogenesis of pernicious anemia and polycythemia rubra vera.
A review of the literature reveals several instances of polycythemia developing in association with liver therapy, and a few cases of typical polycythemia vera associated with or following treatment for classic
This 100-word excerpt has been provided in the absence of an abstract.
Summario in Interlingua
Es describite le caso de un masculo blanc de 58 annos de etate qui disveloppava polycythemia mortal post administrationes de vitamina B12 como tractamento de anemia perniciose. Le patiente habeva essite tractate durante quatro annos con raffinate extracto hepatic pro un anemia megaloblastic macrocytic que esseva associate con achlorhydria e neuropathia peripheric. Leucocytosis habeva essite presente durante le integre intervallo de quatro annos, per contrasto con lo que es usual in casos de leucopenia.
In decembre 1949 un recidiva hematologic e neurologic occurreva. Isto se corrigeva post administrationes de vitamina B12. Le patiente recipeva injectiones de vitamina B12 un vice per mense usque a augusto 1950. Un mense plus tarde le hemoglobina esseva normal, sed un marcate leucocytosis polymorphonuclear esseva constatate. In novembre 1950 le patiente suffreva un accidente cerebrovascular, e il esseva constatate que le hematocrite monstrava un valor de 79 pro cento. Nulle tendentia hemorrhagic esseva detegibile. Le morte interveniva 16 dies plus tarde.
Le necropsia revelava multiple areas de hemorrhagia e necrosis in le cerebro. Le hepate e le splen esseva allargate, sed nulle allargamento de nodos lymphatic esseva notate e nulle infiltration leucemie in ulle organo. Le medulla ossee esseva hyperplastic. Nulle thromboses in vasos peripheric esseva detegite.
Un revista del litteratura revelava le previe occurrentia combinate de anemia perniciose e polycythemia in le mesme patiente. Le nivello del numeration sanguinee ha frequentemente essite relationate al dosage de hepate. Depost le discoperta de vitamina B12, plure casos de responsa polycythemic a vitamina B12 ha essite reportate. Le caso del presente reporto es le prime mortal.
Le existentia de anemia perniciose e de polycythemia ver in iste patiente es considerate como un coincidentia, sed il es interessante specular que forsan le carentia de vitamina B12 preveniva le disveloppamento complete del polycythemia.
Article and Author Information
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↵* Received for publication March 21, 1956.
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From the Department of Surgery, Cleveland City Hospital, and the School of Medicine, Western Reserve University.
