Shirakawa C, Ohno M, Sugishima H, Morita S, Masaki H, Fujimoto T, Maeda Y, Irimajiri K, Horiuchi A
Rinsho Ketsueki. 1992 Aug;33(8):1031-5.
A 52-year-old woman was admitted to our hospital because of leukocytosis. She had been diagnosed with RAEB in another hospital in past time. At the admission, the white cell count was 30,900/microliter with blasts (14.0%) and marked basophilia (49.0%). Bone marrow aspiration revealed with 30.2% blasts and 21.1% basophils. Having obtained those results, diagnosis of RAEB in transformation was made. After admission, number of basophils in peripheral blood increased gradually, and level of histamine in serum was elevated significantly. Multiple peptic ulcers in stomach and bowel and high fever were induced due to histaminemia. Despite several therapy she died because of respiratory failure and septisemia. Although the mechanism of basophilia in this patient could not be clarified, there was a possibility that basophilia in this patient might be differentiated from leukemic clone because almost basophils in peripheral blood were mature and those had many granules including metachromasia by stained with toluidine blue.
一名52岁女性因白细胞增多症入住我院。她曾在其他医院被诊断为难治性贫血伴原始细胞过多（RAEB）。入院时，白细胞计数为30,900/微升，原始细胞占14.0%，嗜碱性粒细胞显著增多（49.0%）。骨髓穿刺显示原始细胞占30.2%，嗜碱性粒细胞占21.1%。根据这些结果，诊断为RAEB转化型。入院后，外周血中嗜碱性粒细胞数量逐渐增加，血清组胺水平显著升高。组胺血症导致胃和肠道多发消化性溃疡及高热。尽管进行了多种治疗，她仍因呼吸衰竭和败血症死亡。虽然该患者嗜碱性粒细胞增多的机制尚不清楚，但有可能该患者的嗜碱性粒细胞增多与白血病克隆不同，因为外周血中的嗜碱性粒细胞几乎都是成熟的，且经甲苯胺蓝染色后有许多包括异染性的颗粒。
