DISSEMINATED TUBERCULOSIS AND BONE MARROW DYSCRASIAS

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Abstract
Summary: The clinical features and autopsy findings are described in two cases of pancytopenia, four cases of leukæmia and one case of myelofibrosis, all of which were associated with disseminated tuberculosis.It is considered that tuberculosis preceded and may have caused pancytopenia in three cases. Diagnosis in such cases is aided by biopsy of lymph glands, liver and bone marrow from the iliac crest, and by culture of biopsy material. The pancytopenia should respond to anti‐tuberculous chemotherapy, but in one case it progressed to leukæmia despite treatment.Tuberculosis appeared as a complication in three cases of leukæmia and in one case of myelofibrosis. These cases pursue their natural course despite anti‐tuberculous chemotherapy. Tuberculosis seems more likely to occur in patients receiving cortisone.We consider that “ leukæmoid reaction ” to tuberculosis is not common, and that, more commonly, leukæmia is complicated by tuberculosis. In a few cases tuberculosis may be an ætiological factor in the blood dyscrasia, most commonly in cases of pancytopenia.