興味ある血液学的異常をきたした神経性食思不振症の2症例

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概要

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• Two young female patients with severe anorexia nervosa (cases K. O. and T. U.) who had moderate pancytopenia were studied.The peripheral hematological examination revealed normochromic anemia (248x104/cmm, 277x104/cmm), granulocytopenia (1071/cmm, 1255/cmm), lymphopenia (1071/cmm, 1225/cmm) and moderate thrombocytopenia (12.4x104/cmm, 15x104/cmm). In case K. O. a large number of spur-shaped erythrocytes were observed on the smears of the peripheral blood.In both cases bone marrow aspiration and biopsy revealed a large amount of sticky gelatinous material. It was suggested to be acid mucopolysaccharide histochemically as described by H. A. Pearson.The hematopoietic cells were scattered in clusters and histiocytes containing ceroidlike pigments were also seen. Bone marrow differentials showed a decrease in myeloid series and megakaryocytes but erythropoiesis did not seem to be so suppressed as other cell series.In hemostatic tests euglobulin lysis time was shortened and a slight decrease in factor VIII and prothrombin was observed.The more detailed studies performed in case K. O. were as follows: 1) Mean red cell survival studied with DF32P was reduced (61 days). 2) A normal total red cell volume expressed in terms of body weight was seen with an increase in total plasma volume. 3) Plasma iron disappearance time and red cell utilization were normal and plasma iron turnover was accentuated. 4) Whole body scan at 5 to 24 hours after injection of 59Fe, which reflects the erythropoietic marrow distribution, demonstrated normal peaks in the sternum and pelvis and an increased uptake in the mid vertebrae. An increased uptake in the spleen at 10 days suggested hemolysis in the circulation.In case T. U. the pripheral blood picture recovered to the almost normal level along with the improvement of appetite four months later.The pathogenesis of these various hematological abnormalities in patients with anorexia nervosa remains to be elucidated.

• 一般社団法人 日本血液学会の論文

一般社団法人 日本血液学会 | 論文

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