PANCYTOPENIA ASSOCIATED WITH DISSEMINATED TUBERCULOSIS, REACTIVE HISTIOCYTIC HEMOPHAGOCYTIC SYNDROME AND TUBERCULOUS HYPERSPLENISM

A 38-year-old black male is reported with a rare combination of dissem inated tuberculosis together with a reactive histiocytic haemophagocyt ic syndrome and tuberculosis hypersplenism. Tuberculosis and histiocyt ic haemophagocytosis were diagnosed on bone marrow examination. The pa ncytopaenia and splenomegaly which were present on admission did not r esolve despite adequate anti-tuberculosis chemotherapy. Prior to splen ectomy the patient continued to have a marked thrombocytopenia which r esulted in recurrent bouts of epistaxis; splenectomy together with tub erculostatic therapy was curative for the condition. The patient remai ns well with normal blood counts 1 year later.