抗痙剤による巨赤芽球性貧血

概要

論文の詳細を見る
A case of megaloblastic anemia due to anticonvulsant drug (diphenylhydantoin and phenobarbital) is reported for the first time in Japan. He was an inpatient of a mental hospital. He did not respond to vitamin B12, but clinical and hematologic remission followed immediately after the administration of folic acid.The hematologic studies of other patients in the same mental hospital were performed. Slight anemia (normochromic or hyperchromic) was observed in 56% of 16 patients receiving diphenylhydantoin. Sixty-nine of these 16 patients had macrocytosis. MCV value of over 95 μ3 is recommended as the index of macrocytosis. Slight anemia and macrocytosis were improved after the daily administration of 5 mg of folic acid for 25 days. On the other hand, 7 patients who had been receiving other anticonvulsants (Mysoline, phenobarbital) and 14 control patients who had not been epileptic did not show macrocytosis. Three of 4 anemic patients receiving diphenylhydantoin showed impaired absorption of d-Xylose, but they showed normal value after the administration of folic acid.It is suggested that a considerable number of patients receiving anticonvulsant have the disturbance of folic acid metabolism.
一般社団法人日本血液学会の論文