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Arsenic intoxication presenting as a myelodysplastic syndrome: A case report
Author(s) -
Rezuke William N.,
Anderson Crawford,
Pastuszak William T.,
Conway Stephen R.,
Firshein Stephen I.
Publication year - 1991
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830360415
Subject(s) - medicine , myelodysplastic syndromes , differential diagnosis , arsenic poisoning , bone marrow , pancytopenia , pediatrics , arsenic , pathology , materials science , metallurgy
A case of arsenic intoxication presenting as a myelodysplastic syndrome is reported. A 41‐year‐old woman with a 6‐month history of gastrointestinal and neurological symptoms was noted to be pancytopenic at presentation. A bone marrow aspirate revealed dysmyelopoietic changes involving all three marrow cell lines. Subsequent analysis of urine for heavy metals demonstrated very high levels of arsenic. Treatment with British anti‐Lewisite (BAL) resulted in the resolution of gastrointestinal symptoms and hematologica abnormalities although the neurological complications progressed. This case emphasizes that heavy metal intoxication should be considered in the differential diagnosis of any individual presenting with the hematological features of myelodysplasia especially when accompanied by clinical features considered atypical for primary or secondary myelodysplasia.