Mycobacterium avium Complex Inclusions Mimicking Gaucher's Cells

To the Editor: A 37-year-old man with insulin-dependent diabetes mellitus complicated by end-stage renal disease who had received a second cadaveric kidney transplant four years earlier presented with symptomatic splenomegaly, progressive anemia, prolonged fever, dysphagia, and weight loss. Owing to chronic rejection of his kidney transplant, he required intensive immunosuppressive therapy consisting of tacrolimus, mycophenolate mofetil, and prednisone. The first kidney transplant, as well as a pancreatic transplant, had been lost because of acute rejection, seven and three years previously, respectively. Abdominal computed tomography performed on admission revealed splenomegaly with a subcapsular hematoma. Analysis of a bone marrow aspirate revealed . . .