Takigawa A, Kajigaya Y, Funabiki T, Fukazawa K, Ikuta K, Sasaki H, Matsuyama S, Terasawa T, Shichishima T, Kanzaki A
Rinsho Ketsueki. 1989 May;30(5):713-8.
A seven year-old boy with hereditary stomatocytosis complicated with aplastic anemia was reported. He was admitted to our hospital because of pale and general fatigue. On physical examination, he had severe anemia, petechiae, but no hepatosplenomegaly. Peripheral blood cell count revealed pancytopenia; RBC 103 X 10(4)/microliters, Hb 3.5 g/dl, Ret 21%, WBC 1,200/microliters, Pl 1.3 X 10(4)/microliters, and bone marrow revealed markedly hypocellular marrow. Red cell morphology demonstrated stomatocytosis. Red cell life span (51Cr T1/2) was 12 days, Coombs' test and Ham's test were negative. Indirect bilirubin was 1.1 mg/dl and marked decrease of haptoglobin was found. Family studies showed that his father and sister had stomatocytosis on peripheral blood examination, but no anemia. The patient had severe anemia because of complicated aplastic anemia. Congenital stomatocytosis with aplastic anemia is extremely rare. The authors are interested in a possible relationship between hereditary stomatocytosis and aplastic anemia although the precise mechanism remains to be elucidated.
报道了一名患有遗传性口形红细胞增多症并伴有再生障碍性贫血的7岁男孩。他因面色苍白和全身乏力入院。体格检查发现他有严重贫血、瘀点,但无肝脾肿大。外周血细胞计数显示全血细胞减少;红细胞103×10⁴/微升,血红蛋白3.5克/分升,网织红细胞21%,白细胞1200/微升,血小板1.3×10⁴/微升,骨髓显示骨髓细胞明显减少。红细胞形态显示口形红细胞增多。红细胞寿命(⁵¹Cr T1/2)为12天,库姆斯试验和汉姆试验均为阴性。间接胆红素为1.1毫克/分升,发现触珠蛋白明显降低。家族研究表明,他的父亲和姐姐在外周血检查中有口形红细胞增多症,但无贫血。该患者因并发再生障碍性贫血而患有严重贫血。先天性口形红细胞增多症伴再生障碍性贫血极为罕见。尽管确切机制尚待阐明,但作者对遗传性口形红细胞增多症与再生障碍性贫血之间可能的关系感兴趣。