Acute Tuberculosis and Granulocytic Disorders

Abstract

During the past 60 years the possibility that a special relation exists between tuberculosis and haematological abnormalities has occupied the thoughts of many investi gators. Most of the early observations were made in German-speaking countries and were summarized in 1939 by Siegmund. Among the original descriptions were instances of a particularly acute form of tuberculous miliary necrosis with depressed blood formation which varied from a simple leucopenia affecting mainly the granulocytes to agranulocytosis and pancytopenia. Other authors noted the development of acute tuberculosis in patients with myeloid leukaemia. Later writers have con firmed these findings but have failed to agree upon the extent to which the tuberculosis may influence the behaviour of the bone-marrow. For example, the haemato logical changes that occasionally accompany acute tuber culosis may resemble acute leukaemia in that primitive white cells appear in the blood and marrow, but at post mortem examination no conclusive evidence of leukaemia can be found, there being no leukaemic infiltration of the tissues. Sometimes, when the blast cells are particularly numerous, an underlying acute leukaemia is presumed, and indeed would probably be diagnosed as such were it not for the tuberculosis. At other times the abnormal white cells are less primitive and a so-called leukaemoid reaction is suspected.