Transient Histiocytosis With Striking Phagocytosis of Platelets, Leukocytes, and Erythrocytes

Abstract

The term "histiocytic medullary reticulosis" first was introduced by Scott and Robb-Smith1 to describe a disorder of the reticuloendothelial system characterized by fever, hepatosplenomegaly, progressive anemia, leukopenia, thrombocytopenia, and, usually, a fatal outcome. Morphologically, there is a neoplastic proliferation of histiocytes in the medullary portions of lymph nodes, intense erythrophagocytosis, and varying degrees of leukophagocytosis and thrombophagocytosis. Nearly 100 case reports of this disorder have been published to date.^2-13 This report describes the cases of two patients who had many of the classic signs and symptoms of this disease, including erythrophagocytosis, leukophagocytosis, and thrombophagocytosis, that were completely reversible. These findings were associated with a viral-like illness in one patient and miliary tuberculosis in the second patient. Both patients are alive and well four years and two years later, respectively, and are totally asymptomatic. PATIENT SUMMARIES Patient 1. —A 19-year-old man was hospitalized because of fever and muscle aches