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Dengue fever mimicking plasma cell leukemia
1Department of Laboratory Medicine, Lahey Clinic, Burlington, Mass 01805, USA. john.m.gawoski@lahey.org
Archives of Pathology & Laboratory Medicine
|July 23, 2003
Summary
Extreme plasmacytosis, a rare blood condition, was observed in a dengue fever patient. This case highlights that severe plasmacytosis can be a transient finding in acute infections, not always indicating malignancy.
Area of Science:
- Hematology
- Infectious Diseases
- Clinical Medicine
Background:
- Extreme plasmacytosis in peripheral blood is typically associated with plasma cell leukemia.
- It can rarely be linked to other malignancies, infections, or drug reactions.
Observation:
- A 40-year-old man presented with acute febrile illness and thrombocytopenia.
- Initial blood work revealed 19% plasma cells (1100/microL) and 9% abnormal plasmacytoid lymphocytes (520/microL).
- Symptoms and hematologic findings resolved within 3 days.
Findings:
- Serologic testing confirmed dengue infection (immunoglobulin M positive).
- This is the first reported case of extreme plasmacytosis associated with dengue fever.
- Atypical lymphocytosis is a known complication of dengue.
Implications:
- Transient extreme plasmacytosis can occur in acute infectious illnesses like dengue.
- In dengue-endemic areas, consider acute illness as a cause of plasmacytosis before extensive workup.
- This finding broadens the differential diagnosis for marked plasmacytosis.