Leprosy and bone marrow involvement

<span class="paragraphSection">A 29-year-old female had a history of hypopigmented skin lesions over the left cheek, back and thighs for over 3 years. These lesions were not associated with itching or any altered sensation but were progressively increasing in size and number. She took indigenous medications for 3 years with no response. Finally, she visited our hospital for her complaints and a skin biopsy confirmed a diagnosis of leprosy. She was started on multi drug therapy. No new lesions developed following therapy and her existing lesions also reduced in size. On follow-up, after about 6 months, she started developing progressive anemia. Nutritional causes were excluded and drugs were stopped; however, the anemia persisted. The patient started experiencing intermittent and high-grade fever as well. On examination, she had pallor, was febrile (103°F) and had multiple skin lesions (<a href="#hcw204-F1" class="reflinks">Figure 1A</a>). Complete blood counts revealed anemia (Hemoglobin - 80 g/L, Total leukocyte count-8.6 × 10<sup>9</sup>/L and platelet count –201 × 10<sup>9</sup>/L). Her blood and urine cultures were sterile and other infective work-up was negative. Finally, a bone marrow examination was performed to evaluate the cause of anemia and persistent fever. Bone marrow aspirate smears showed adequate representation and maturation of all hematopoietic lineage elements, however, had many foamy macrophages (<a hre...
Source: QJM - Category: Internal Medicine Source Type: research