title: [Leptospira, does it simulate or cause leukemia?].
abstract: Two cases of chronic leptospirosis in bicitopenic and pancitopenic patients, respectively, with mucocutaneous and visceral bleedings were presented. They were diagnosed myeloblastic leukemia M3 and acute lymphoblastic leukemia L2 by bone marrow aspiration and they were treated as such at the hematology department of a general hospital. Both patients died after one of them had considerably improved on being treated with sodium crystalline penicillin at high doses. The histopathological studies could not demonstrate the presence of neoplastic cells in bone marrow but leptospiras were found by means of silver stained preparations (Warthin - Starry) and immunofluorescence, both in this organ and in other tissues studied: kidney., spleen, liver and lungs. The histopathological diagnoses were generalized leptospirosis with medullary aplasia and generalized leptospirosis with myelodisplastic syndrome, respectively. It was reviewed the possibility that leptospira could cause leukemoid syndromes and/or leukemia. Based on these results, it is recommended to hematologists, infectologists, pathologists, and others, to use again the technques of argentic impregnation, immunohystochemistry and immunofluorescence to study the bone marrow and other tissues in order to detect the possible presence of leptospira that would allow to treat the patients more effectively, particularly, patients like these that had serological titres considered negatives so as to avoid the false security existing in the official health institutions about the minimum or null impact that leptospirosis cause in public health, which imply the absence of control systems for this spirochetosis.
authors.affiliation: Laboratorio de Medicina Tropical, Unidad Medicina Experimental, Facultad de Medicina, UNAM - Hospital General de México. oscarvel1@yahoo.com
authors.forename: Oscar
authors.initials: O
authors.lastname: Velasco-Castrejón
authors.forename: Beatriz
authors.initials: B
authors.lastname: Rivas-Sánchez
authors.forename: Esther
authors.initials: E
authors.lastname: Gutiérrez
authors.forename: Laura
authors.initials: L
authors.lastname: Chávez
authors.forename: Paulo
authors.initials: P
authors.lastname: Duarte
authors.forename: Salvador
authors.initials: S
authors.lastname: Chavarria
authors.forename: Héctor Hugo
authors.initials: HH
authors.lastname: Rivera-Reyes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000382:microbiology; D001856:Bone Marrow Examination; D002908:Chronic Disease; D005455:Fluorescent Antibody Technique; D006801:Humans; D007668:Kidney / Q000382:microbiology; D007919:Leptospira / Q000302:isolation & purification; D007922:Leptospirosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D008168:Lung / Q000382:microbiology; D008297:Male; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D016622:Silver Staining