PMC3262644_01
Photomicrographs of bone marrow aspiration. (a) Decreased nucleated cells with fat replacement in bone marrow at diagnosis (b) Increased nucleated cells with an absence of fat replacement (HE staining x100).
ENDOCRINOLOGY2011-732623.001.jpg
PMC3262644_01_ENDOCRINOLOGY2011-732623.001.jpg
fig1
There were decreased nucleated cells with fat replacement in BM (Figure 1(a)). The patient was administered iodide 126 mg/day and imipenem/cilastatin 2 g/day and G-CSF was increased to 300 mug/day. Two days later, intravenous amikacin (400 mg/day) was added; however, with a progressive depression in peripheral blood count, the patient needed transfusions of erythrocytes and platelets. A second bone marrow aspiration was performed 3 weeks later and BM was already normocellular (Figure 1(b)); thus she was administered 131I radioniodine, and 2 months later her thyroid function was normal.
Illustration of the clinical course of the case. MMI: methimazole, FMOX: flomoxef, AMK: amikacin, IPM/CS: imipenem/cilastatin, M-PSL: methyprednisolone, CyA: cyclosporin, BMA: bone marrow aspiration, Neu: neutrophils.
ENDOCRINOLOGY2011-732623.002.jpg
PMC3262644_01_ENDOCRINOLOGY2011-732623.002.jpg
fig2
The clinical course of this case is illustrated in Figure 2.