vitamin-b-12 and Keratosis

Dyskeratosis congenita is a rare genodermatosis whose hematologic complications include pancytopenia of variable time of onset, a propensity for opportunistic infections, and neoplasia. A family in which the disorder segregated in 3 generations and involved 9 members is reported, and the hematologic data of the 46 previously reported cases are reviewed.

Topics: Adult; Alkaline Phosphatase; Blood Coagulation; Bone Marrow; Fetal Hemoglobin; Folic Acid; Humans; Keratosis; Leukoplakia; Male; Nails; Pancytopenia; Pedigree; Pigmentation Disorders; Skin Diseases; Vitamin B 12

We have described a case of chronic arsenic intoxication associated with pancytopenia and megaloblastic erythropoiesis. The patient had the typical laboratory manifestations of effective erythorpoiesis due to a megaloblastic process, including macroovalocytes, mild pancytopenia, low reticulocyte index, increased marrow cellularity with erythroid hyperplasia, and morphologic evidence of megaloblastic maturation in the marrow. The patient's serum folate and vitamin B12 were normal, and the anemia regressed without therapy. Our case suggests that the combination of megaloblastosis with normoblastic or megaloblastic karyorrhexis,should raise the suspicion of arsenic intoxication in the mind of the observer. In addition, arsenic should be added to the list of agents causing a reversible megaloblastic anemia.

Topics: Anemia, Macrocytic; Anemia, Megaloblastic; Arsenic; Arsenic Poisoning; Bone Marrow Examination; Erythropoiesis; Folic Acid; Hair; Humans; Keratosis; Liver; Male; Middle Aged; Nails; Neural Conduction; Neurologic Manifestations; Remission, Spontaneous; Reticulocytes; Vitamin B 12