Acquired pyruvate kinase deficiency with hemolysis in preleukemia

Acquired erythrocyte pyruvate kinase deficiency may appear as a symptom secondary to various hematologic disorders, e.g. acute leukemia, sideroblastic anemia, polycythemia vera. The case of a 68-year-old patient with PK deficiency (1.75 U/g Hb) and severe hemolytic anemia is presented, who 1 year later showed acute myeloid leukemia. It is considered that a dialysable inhibiting factor may play a pathogenetic role in this enzyme change since enzyme activity was raised by dialysis. A survey of the literature is presented.