Pancytopenia and hepatosplenomegaly in oxalosis

A 25-year-old woman with oxalosis and end-stage renal disease had pancytopenia and massive hepatosplenomegaly associated with extensive bone marrow deposition of calcium oxalate. A ferrokinetic study suggested profound reduction in erythrocyte production, and peripheral blood smears were compatible with myelophthisis and extramedullary hematopoiesis. Mechanical obliteration of bone marrow by calcium oxalate crystals may lead to pancytopenia and hepatosplenomegaly as late extrarenal complications of oxalosis.