Elevated Muramidase Levels in Histiocytic Medullary Reticulosis (Cont.)

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Abstract
To the Editor: Firkin1 and more recently Duffy et al. (N Engl J Med 294:167–168, 1976) reported raised concentrations of serum and urine lysozyme (LZM) respectively, in patients with histiocytic medullary reticulosis (HMR).We measured, over a six-month period, the concentration of serum and urine LZM in a 24-year-old man with the typical symptoms and signs of HMR: fever, lymphadenopathy, hepatospleno-megaly, a normal erythrocyte sedimentation rate, hemolytic anemia, thrombocytopenia, erythrophagocytosis in the bone marrow and typical splenic and lymph-node histology. There was no hyr pokalemia, no marked monocytosis and no impairment of renal function. He responded poorly to chemotherapy . . .