Portal cirrhosis.

Abstract

cells, 2,050,000; hgb. (Sahli), 45 per cent; white blood cells, 2,400, with polymorphonuclear leucocytes 63 per cent, lymphocytes 31 per cent, mononuclear cells 5 per cent, and eosinophiles 1 per cent. The absolute scarcity of blood platelets precluded an accurate count. Vital staining for reticulocytes revealed only three reticulated erythrocytes after careful search of approximately 12,000 cells. Blood smears revealed erythrocytes of normal size and shape, but with a considerable degree of hypochromia. Bleeding and coagulation times were slightly prolonged. The red cell fragility test was within normal limits, as was the sedimentation rate. The serum calcium level was normal. The capillary resistance test was strongly positive, and it was noted that wherever the finger was punctured a small zone of subdermal heemorrhage resulted. Efforts to determine a toxic factor in this case were unsuccessful. No focus of infection was demonstrable in nose, sinuses, throat, or teeth. The final diagnosis was idiopathic aplastic antemia, with grave prognosis. The patient returned to her home in a distant city on the third day after admission. The therapeutic use of small frequent blood transfusions was recommended to the patient's physician but, in spite of this treatment, she expired within one month. An autopsy was not obtained.