Leukopenic Myeloid Leukemia Associated With Arthritis

Arthritis has rarely been described in association with any form of leukemia. The following case is interesting because of the unusual clinical picture in a 3 year old child who was studied over a period of nine months. The white cells in the early stage of the disease showed a moderate increase in numbers, to be supplanted later by a marked leukopenia. Immature myeloid cells were identified in the blood smear. Biopsy of a lymph node revealed infiltration with cells of the myeloid series. A severe anemia coexisted with the leukopenia. At the same time arthritic manifestations and a febrile course were sufficiently pronounced to simulate rheumatic fever. The involvement of the joints, however, did not yield to the ordinary therapeutic agents and appeared to be related to the blood disorder. Roentgenograms of the osseous system revealed profound changes in the bone which were interpreted as leukemic in origin. Postmortem