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January 1972

Histiocytic Medullary Reticulosis: Fatal Hemorrhage Due to Massive Platelet Phagocytosis

Author Affiliations

Brooklyn, NY

From the Division of Hematology, Department of Medicine, Maimonides Medical Center, Brooklyn, NY (Drs. Seligman, Lee, and Kagan) and the Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY (Drs. Rosner and Lee).

Arch Intern Med. 1972;129(1):109-113. doi:10.1001/archinte.1972.00320010113015

Histiocytic medullary reticulosis was first described as a clinical and pathological entity by Scott and Robb-Smith in 1939. 1 The clinical picture includes fever, wasting, lymphadenopathy, hepatosplenomegaly, and progressive pancytopenia. The outstanding morphologic feature of the disease is proliferation of histiocytes throughout the lymphoreticular system and frequent erythrophagocytosis. Most patients die within six months after onset of disease; the average duration before death is 15 weeks. The disease occurs in adults between the ages of 20 and 70 years and there is a 3:1 male predominance.2,3

The case reported here was unusual in that the patient manifested severe thrombocytopenia which was thought to be due to massive platelet phagocytosis by abnormal histiocytes. He died of massive gastrointestinal hemorrhage.

Patient Summary  A 21-year-old white man presented on Jan 13, 1968, because of six weeks of anorexia, weakness, weight loss, daily fevers to 104 F (40 C), and bilateral cervical

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