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Gregory R. Favis, MD; John A. Schmidt, MD; William G. Kussmaul, MD; William G. Negendank, MD; Sanford J. Shattil, MD
Hospital of the University of Pennsylvania Philadelphia

JAMA. 1978;240(18):1953.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Disseminated intravascular coagulation with hypofibrinogenemia is an unusual complication of acute leukemia, especially acute promyelocytic leukemia.¹ However, hypofibrinogenemic bleeding as a complication of chronic myelogenous leukemia (CML) must be a rare event, since this has been reported only once previously.² We report an additional case of CML in which hypofibrinogenemia appears to have played a major role in the patient's death.

Report of a Case.—

A 57-year-old man was admitted to the Philadelphia Veterans Administration Hospital complaining of three days of nausea and vomiting, weakness, malaise, and an exacerbation of a previously troublesome frontal headache. He had known CML (Philadelphia chromosome positive) for three years, during which he manifested sharp fluctuations in his peripheral WBC counts (20,000/cu mm to 150,000/cu mm) in the absence of chemotherapy.

On admission his medications included allopurinol and hydrochlorothiazide. Physical examination showed an ill-appearing man. His blood pressure was 170/90 . . . [Full Text PDF of this Article]

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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