A Case of Dermatomyositis associated with prominent monocytic leukemoid reaction developed on eighteen months after the radical stomach cancer's operation

A 48 years old male patient with dermatomyositis associated with prominent monocytic leukemoid reaction is reported. He received the radical operation of stomach cancer on April, 1978, and was quite well until he complained of fever, backache, difficulty in swallowing and rash on the 18 months after the operation. On hematologic examinations, WBC count was 132, 000/mm with a differential count of 4% promyelocytes, 4% myelocytes, 11% metamyelocytes, 32% stab., 8% segment, 35% monocytes and 6% lymphocytes. On other examinations, serum CPK, GOT, aldolase and lysozyme levels increased. He was initially treated with predonisolone and showed a marked improvement not only in clinical symptoms but also in hematological findings. Laboratory data became normal soon thereafter. But, several month later, he relapsed and died of heart failure in spite of intensive treatment.