Fatal Aplastic Anaemia after Treatment of Thyrotoxicosis with Potassium Perchlorate

Abstract

nodes in the neck.Blood: haemoglobin 630%; W.B.C. 2,900 (98% lymphocytes, 2% polymorphs); platelets 20,000; bleeding-time (Duke) 30 minutes; coagulation time 4 minutes.Sternal marrow (April 20): complete absence of erythropoietic and granulopoietic cells and of mega- karyocytes.The cells present were mostly lymphocytes and plasma and reticulum cells; and the marrow picture was typical of aplastic anaemia.In her final illness the patient was treated with penicillin, streptomycin, fresh blood trans- fusion, and steroids; but she died five days later with signs of severe pulmonary infection.Post-mortem Examination.-Thebody was adequately nourished and slightly jaundiced, with scattered purpuric spots.There were scattered petcchiae on the pericardium and on mucous membranes, with haemorrhagic consolida- tion in the lungs and pleurisy on the surface of the lower lobes.The spleen was firm and dark, the marrow of vertebrae appeared normal, but the femoral marrow was pale.The right lobe of the thyroid was slightly enlarged.