First Case of Chronic Myeloid Leukaemia Associated Microfilariasis at the Brazzaville University Hospital

Lethso Thibaut Ocko Gokaba, Olivia Firmine Atipo Galiba, Géril SEKANGUE OBILI, Lydie Ocini Ngolet, Alexis Elira Dokekias
2020 Journal of Clinical and Diagnostic Research  
A 47-year-old, male community health agent, living in a forest area in the north of the Congo, presented to the haematology department for a severe left upper abdominal pain, with a history of seven months abdominal pain and progressive fatigue. After physical examination of the patient, we found pallor, hands and ankle oedema, a hepatomegaly with smooth lower border (22 cm in right mi-clavicular line) splenomegaly but no signs of filaria. The rest of the physical examination was unremarkable
more » ... was unremarkable and no radiographical examination was done. Full blood count showed: leukocytes: 114,000/mm 3 ; haemoglobin: 7.8 g/dL; haematocrit: 23.8%; MCV: 84, 4 fL, platelets: 310,000/mm 3 . Blood smear: blasts: 4,580/mm 3 ; myelocytes: 8,020/mm 3 ; metamyelocytes (mauve arrow): 27,520/mm 3 ; neutrophils: 56,200/mm 3 ; eosinophil: 14,910/mm 3 and erythroblasts: 3,440/mm 3 . ABSTRACT The association between Chronic Myeloid Leukaemia (CML)-Filariasis is rare. Moreover, finding microfilariae in the bone marrow is uncommon. We reported the case of 47-year-old patient living in a rural area who was admitted in the haematology ward in order to further examine a splenomegaly he had which was associated with a leucocytosis. Physical examination revealed oedematous lower limbs and peripheral blood film comment showed the presence of myelocytosis and eosinophilia. The myelogram showed hyperplasia of immature granulocytes and presence of Loa loa, Wuchereria bancrofti and Mansonella perstans microfilariae. The diagnosis of CML was then confirmed by the presence of the gene translocation t (9; 22) and the MBCR-ABL transcription type b3a2 on cytogenetic examination. This case represents a semiotic interest because oedema of both upper and lower limbs associated with a leucocytosis in filarial endemic zone must first of all indicate a haematological malignancy associated with filariasis.
doi:10.7860/jcdr/2020/42441.13410 fatcat:xpa3as724fao3hkvqxgfq3nwn4