Aplastic anaemia from chronic exposure to white spirit

A 41 year old male had worked as a heavy equipment mechanic for 16 years, which involved frequent exposure to a chemical mixture containing Stoddard solvent. He had been well until three months prior to hospital admission, when he began to experience progressive tiredness, light-headedness, and increased bruising. Some ecchymotic areas and diffuse petechiae were noted on initial physical examination. There was no palpable hepatomegaly or splenomegaly. Initial investigations showed anaemia, thrombocytopenia and leucopenia. A sternal marrow biopsy was performed, but no marrow particles were found, and subsequent percutaneous bone biopsy of the iliac crest showed a markedly hypocellular bone marrow with a scarcity of all cellular components. The other investigations were normal. Eleven months after the initial diagnosis the patient was admitted to hospital in a coma and died. Postmortem examination revealed diffuse intracerebral haemorrhage involving the right occipital lobe. The bone marrow exhibited the previously noted hypocellularity with depression of all cellular components (Prager and Peters, 1970).

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