Histiocytic Medullary Reticulosis

Abstract

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.