A Middle-aged Man with High-grade Fever, Non-productive Cough, Weight Loss for 2 Weeks
Keywords:
Pancytopenia, promyelocytic leukemia, high-grade feverAbstract
A 55-year-old man, a carpenter in northeastern Thailand with no underlying disease presented with acute onset of fever with chills, non-productive cough, weight loss of 3 kilograms in 2 weeks. He also experienced easily fatigue and tiredness for 1 month. He went to local hospital and was diagnosed pancytopenia. He received 3 units of packed red cells and 1 unit of platelet concentrate without significant improvement. Then he was referred to another hospital for investigation. After blood smear review, there were many abnormal white blood cells with numerous small cytoplasmic granules. The bone marrow examination and cytogenetics revealed diagnosis of acute promyelocytic leukemia. So, in case of pancytopenia without apparent causes, blood smear and bone marrow examination can be helpful in definite diagnosis.
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