Acute Myeloblastic Leukemia*
The patient, an unmarried white woman, 47 years of age, was brought to the hospital in an ambulance. Her chief complaint was pain in the abdomen. Two weeks previous to this examination, while walking, she had fallen on her back and after this she had become nauseated, faint and had suffered from intense cramplike pains across the upper part of the abdomen. The symptoms persisted, but she was able to continue her duties as a social worker until one week before admission to the hospital. Since that time she had been confined to bed. The abdomen became distended and tender, she had some fever and two days prior to admission she became jaundiced. She was constipated and strong cathartics had been required. The color of the urine was darker than usual.
In addition to the usual diseases of childhood, the patient had had influenza in 1918, and scarlet fever in 1926, which had been complicated by periarthritis of the knees and by nephritis. A tonsillectomy had been performed in 1928.
Examination: On admission to the hospital, the patient's temperature was 101° F., pulse rate 126, respiratory rate 20, blood pressure, 148 systolic, 74 diastolic. The patient appeared to be well developed and nourished; she was uncomfortable and seemed to be in a state of toxemia. The skin and sclerae were icteric. There were some discolorations, swelling and tenderness about the left ankle and there was tenderness over the region of the right kidney. Adenomata were palpable in the right lobe. . .