Patients may show pancytopenia, hypoplastic
anemia, acute myelomonocytic leukemia, or decreased bone marrow mitotic
activity. On examination, cerebellar ataxia, brisk deep tendon reflexes,
bilateral Babinski reflexes, diminished vibratory sensation in the legs, and
unsteady gait can be found. Purpura may be present, and some cases show
telangiectasia or angiokeratomata of the skin. Nystagmus and dysmetria are
often present (cerebellar signs). Patients usually die of hypoplastic anemia
or leukemia.