A case of histoplasmosis in a patient with MDS/MPN-U.

Abstract

TO THE EDITOR: We would like to share the following intriguing case with readers of Blood Research. A 72-year-old HIV-negative man presented with a 2-month history of gradual-onset generalized weakness, low-grade fever, and loss of weight and appetite. On examination, he had pallor and hepatosplenomegaly. His hemogram findings revealed a nearly normal hemoglobin level (11.8 g/dL), leukocytosis (15.8×109/L), and thrombocytopenia (78×109/L). Differential counts showed 3% circulating blasts apart from 6% immature myeloid cells, 4% basophils, and 2% monocytes. A bone marrow aspirate was hypercellular with 5% blasts along with dyserythropoiesis (36%, including 32% ring sideroblasts), dysgranulopoiesis (11%), and dysmegakaryopoiesis (40%). The trephine biopsy showed dyshemopoiesis along with World Health Organization grade 2 reticulin fibrosis. Tests for the detection of BCR-ABL1 fusion gene and JAK2 mutations were negative. A diagnosis of myelodysplastic syndrome/myeloproliferative neoplasm-unclassifiable (MDS/MPN-U) was made [1].