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Absent neutrophil alkaline phosphatase in the eosinophilia myalgia syndrome associated with L-tryptophan use

✍ Scribed by Dr. Jeffrry P. Jaffe; Elie Gertner; Wesley Miller

Publisher: John Wiley and Sons
Year: 1991
Tongue: English
Weight: 213 KB
Volume: 36
Category: Article
ISSN: 0361-8609
DOI: 10.1002/ajh.2830360411

No coin nor oath required. For personal study only.

✦ Synopsis

The clinical constellation of leukocytosis, thrombocytosis, and low or absent stainable neutrophil alkaline phosphatase (NAP) is considered characteristic of chronic myelogenous leukemia (CML) [l]. CML with eosinophilic differentiation (eosinophilic leukemia) is well described [2], and leukemia and other clonal hematologic malignancies are associated with the syndrome of eosinophilic fasciitis [3]. We describe leukocytosis, thrombocytosis, eosinophilia, mild basophilia, and absent stainable NAP, initially suggesting the diagnosis of CML in a patient with the eosinophilia myalgia syndrome associated with L-tryptophan use, a condition resembling eosinophilic fasciitis. Cytogenetic and molecular genetic studies failed to demonstrate a clonal proliferation of eosinophils.

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