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To the Editor.
—An unusually large number of cases of histiocytic medullary reticulosis (HMR) have been reported recently. We wish to describe an additional case.
Report of a Case.
—A patient was seen who had a three-week history of fever and a two-week history of nausea, vomiting, jaundice, and abdominal pain. He was found, on physical examination, to have hepatosplenomegaly, cervical lymphadenopathy, and moderate jaundice. The hematocrit reading was 30%; WBC count, 1,950/ cu mm, with 25% polymorphonuclear leukocytes and 75% lymphocytes; and platelet count, 2,000/cu mm. The results of liver function testing showed a bilirubin level of 16 mg/dL; SGOT level, 490 IU; SGPT level, 110 IU; and serum alkaline phosphatase level, 219 IU. The bone marrow study showed hypercellular marrow with mild megaloblastic change. The patient's condition was treated as a case of acute infectious hepatitis; three days later, signs and symptoms of hepatic encephalopathy and melena developed.
Watananukul P, Suwangool P. Histiocytic Medullary Reticulosis. Arch Intern Med. 1980;140(4):584. doi:10.1001/archinte.1980.00330160144058