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Clinical case review

A presentation of myelodysplasia

Peter A Castaldi

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Abstract

Is leucocytosis in this middle-aged man in the absence of infection an inflammatory condition, a major systemic disorder due to his recently developed gout or something more serious?

Article Extract

Case scenario

Bill, aged 59 years, is a nonsmoker and has, on average, six to eight drinks on four days of each week. He has had hypertension, hypercholesterolaemia and osteoarthritis at least since he first attended your practice two years ago, and has recently developed gout. He takes intermittent colchicine and regular allopurinol for his gout, and is also taking indomethacin, irbesartan and hydrochlorothiazide. There is no recent history of fever or infections, and although he has plethoric facies there are no notable physical findings.

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