Case Report: A Case of Erythremic Myelosis (Di Guglielmo’s Anemia)

A case of erythremic myelosis is described which was characterized by a severe anemia from the beginning. There was irregular remitting fever, splenomegaly and hepatomegaly. The peripheral blood showed immature erythroblasts, granulopenia and thrombocytopenia. The bone marrow showed hyperplasia of erythropoiesis with maturation arrest, and a persistent megaloblastic type of nucleus in abnormal red cells. There was also a well defined proliferation of the reticulo-endothelial system. The course was that of the subacute variety of erythremic myelosis, but it began with an acute phase and ended acutely.

A remission of nearly three months without transfusion followed a transfusion of fresh blood. While this may be coincidental with a spontaneous remission we feel that it is probable that a maturation factor in the fresh blood was responsible. For this reason we feel it is reasonable to suppose that other cases of erythremic myelosis will benefit more from fresh blood than from stored blood; and, as in our case, the inevitable fatal outcome after two months or less can be postponed for an appreciable number of months.