Brief Case Report: Syndrome of Erythremia di Guglielmo after Lightning Injury with Autoimmune Antibodies and Terminating in Acute Monocytic Leukemia

A case of lightning injury is described associated with changes of the hemopoietic system resembling di Guglielmo’s syndrome. Megaloblasts were found in the peripheral blood and bone marrow, resistant to folic acid and vitamin B₁₂ treatment. The presence of auto-immune antibodies in this patient was accompanied by a hemolytic condition not responding to treatment with high doses of prednisolone. Towards the end of the disease the most bizarre-looking erythroblasts were seen in the peripheral blood. Shortly before death the condition suddenly changed into an acute monocytic leukemia. Although it was not proved that the lightning injury caused or precipitated the blood changes, it is thought not to be improbable.