精神的ストレスが発症誘因と考えられたストレス多血症の1例

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In stress polycythemia, various types of stress are closely associated with the development of the disease; however, the exact etiological mechanism remains unknown, Recantly, we found a typical case of stress polycythemia which was apparently induced by emotional stress. The patient was a 61-year-old man. He had been the headmaster of an elementary school until March 1989. After retiring from the school upon reaching the age limit, he was employed as a director of a kindergarten in April 1989. The new job quite different from the previous one and very stressful for him. In November 1989,such symptoms as severe insomnia, lack of energy and ruddy face gradually appeared. He visited Asahikawa Medical College Hospital on January 4,1990 for a medical examination. The hematological findings at the time were : red blood cell count, 6,380,000/μl; hemoglobin, 19.78g/dl; hematocrit, 59.7%; white blood cell count, 5,310/μl;and platelet count, 309,000/μl. Arterial oxygen saturation (SaO_2) and serum erythropoietin level were within normal limits. Splenomegaly was absent and chromosomal analysis of the blood cells showed normal karyotype. Thus, the possibility of polycythemia vera or secondary polycythemia was excluded and a diagnosis of stress polycythemia was made. Since the patient felt unable to endure the work, he was absent from work after January 5,and resigned on January 16,1990. After that, his insomia and other symptoms gradually disappeared. Four weeks after his initial visit to our hospital, patient's red cell count returned to normal without any treatment. This case clearly indicates that emotional stress is a major causative factor of stress polycythemia, and that the latter is a psychosomatic disease. A case of stress polycythemia was documented and the etiology of stress polycythemia was discused by reviewing relevant literature.
日本心身医学会の論文
1991-08-01

精神的ストレスが発症誘因と考えられたストレス多血症の1例

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