HEMOLYTIC ANEMIA, HYPERGLOBULINEMIA AND BOECK'S SARCOID

Abstract

A case associated with Boeck''s sarcoid and hyperglobulinemia occurring in a 46 yr. old 9 is reported here. A diagnosis of hemolytic anemia was made on the basis of increased red cell fragility anemia, spherocytosis and reticulo-cytosis. After splenectomy the blood findings returned to normal. Two months later, clinical symptoms recurred and the patient died in a hemolytic crisis with blood findings typical of hemolytic anemia. At this time the total proteins were 7.6 gs. with 3.6 albumin and 4.0 globulin. At autopsy the bone marrows and lymph nodes showed tubercule-like lesions composed of collagen, monocytes, fibroblasts and giant cells. Material treated with special stains and concentrates was negative for tubercle bacilli and the lesions were interpreted as Boeck''s sarcoid. There were also nodules of aces-sory splenic tissue totalling 2.1 ml. in volume. If this case is one of primary hemolytic anemia, the small amt. of splenic tissue would discount the stasis theory of the pathogenesis of hemolytic anemia. However, it is interpreted as the acquired type and secondary to the sarcoid. It is suggested that hyperglobulinemia occurring in cases of hemolytic anemia is secondary to sarcoidosis and not the anemia.