汎血球減少症を呈した神経性食思不振症の1男性例

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We encountered a 23-years-old male with anorexia nervosa complicated by pancytopenia.The patient developed body weight phobia, hyperacitivity, avodance of food, overeating, and vomiting after going on a diet. The condition fulifilled the diagnostic criteria of anorexia nervosa of the Japanese Ministry of Health and Welfare.On blood analysis, peripheral RBC was 342×10^4/mm^3. Hb was 11.1g/dl, indicating normochromic normocytic anemia, and WBC was reduced to 1,900/mm^3,glanulocytes to 880/mm^3,and lymphocytes to 1,144/mm^3. Thrombocytopenia of 6.1×10^4/mm^3 was also noted.Peripheral blood smears revealed anisocytosis, macrocytosis, and poikilocytosis. Bone marrow aspiratioon profile was markedly hypocellular, and three cell series were remarkably decreased. Gelatin-like degeneration was noted on aspiration. Histopathological studies showed a reduction in nucleated cells including megakaryocytes, but the hemopoietic series was relatively intact.In the blood coagulation test, the prothroumbin time and active partial thromboplastin time were prolonged to 13.9 sec. (control : 12.35 sec.) and 42.1 sec. (control : 30.1 sec.), respectively, and the euglobulin lysis time was notably shortened to 20 min. (control : 3-5 hr.).The serum transaminase levels were slightly elevated, and serum cholinesterase and albumin levels were decreased.Endocrinologically, GH was increased to 47.7 ng/ml, and cortisol to 29.0 μg/dl. As for thyroid function, T_3 was 0.4 ng/ml, T_4 was 6.3 ng/dl, and TSH was 10.7 μU/ml, a profile resembling that of primary hypothyroidism.After admission, the body weight of the patient was restored and maintained by cognitive behavioral therapy.All the above abnormalities were alleviated as the body weight recovered and nutritional condition improved.
日本心身医学会の論文
1989-10-01

汎血球減少症を呈した神経性食思不振症の1男性例

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