Bui Audrey, Shah Avani P, Chae Min Y, Popard Peyton, Telivala Bijoy
Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Hematology and Oncology, Cancer Specialists of North Florida, Jacksonville, USA.
Cureus. 2024 Jul 5;16(7):e63934. doi: 10.7759/cureus.63934. eCollection 2024 Jul.
Hereditary spherocytosis (HS) is a hereditary hematologic disorder characterized by fragile spherical red blood cells that are susceptible to hemolysis. HS patients are often asymptomatic or present with anemia; however, serious complications of chronic hemolysis can include cholelithiasis and aplastic crisis. Splenectomy is considered the standard surgical treatment in moderate and severe forms of HS, with the main complication being a life-long risk of infection. Interestingly, our case suggests a possibility of secondary hemochromatosis as a complication of chronic hemolysis seen in HS. A vast majority of hemochromatosis patients possess a genetic predisposition, which increases their serum iron level and iron storage within the reticuloendothelial system. However, we present a case in which the genetic panel for common mutations associated with hemochromatosis resulted as negative. This case emphasizes the need for increased awareness regarding the potential development of idiopathic hemochromatosis in patients with long-standing HS, allowing for prompt intervention and preventing the associated complications.
遗传性球形红细胞增多症(HS)是一种遗传性血液系统疾病,其特征是脆弱的球形红细胞易发生溶血。HS患者通常无症状或表现为贫血;然而,慢性溶血的严重并发症可包括胆结石和再生障碍危象。脾切除术被认为是中度和重度HS的标准外科治疗方法,主要并发症是终生感染风险。有趣的是,我们的病例提示了继发性血色素沉着症作为HS中慢性溶血并发症的一种可能性。绝大多数血色素沉着症患者具有遗传易感性,这会增加他们的血清铁水平以及网状内皮系统内的铁储存。然而,我们报告了一例与血色素沉着症相关的常见突变基因检测结果为阴性的病例。该病例强调了需要提高对长期HS患者发生特发性血色素沉着症潜在风险的认识,以便及时干预并预防相关并发症。