Elis A, Ravid M, Manor Y, Bental T, Lishner M
Department of Medicine, Meir Hospital, Kfar Saba, Israel.
J Am Geriatr Soc. 1996 Jul;44(7):832-4. doi: 10.1111/j.1532-5415.1996.tb03743.x.
Normocytic-normochromic anemia is frequently found in patients with chronic disorders. The pathogenesis, epidemiological and clinical characteristics of normocytic normochromic anemia of unknown cause are not well established. We evaluated the role of bone marrow examination and the clinical course of patients with "idiopathic" normocytic-normochromic anemia.
Patients with normocytic-normochromic anemia underwent a noninvasive evaluation according to a predetermined protocol. Bone marrow aspiration and biopsy were performed in those patients in whom no explanation for the anemia was found. They were later followed at 3 to 6 month intervals.
Thirty-one patients (23 females and 8 males) with "idiopathic" normocytic-normochromic anemia (mean hemoglobin concentration was 10.0 + 0.6 g/dL) were detected. No patient had symptoms related to the anemia. Twenty-nine bone marrow aspirations and 21 biopsies were performed. Iron deficiency and mild myelofibrosis were found in one patient each. The rest of the bone marrow examinations were normal. During 15.5 +/- 10.3 months of follow-up, the hemoglobin level rose marginally to 10.9 + 1.0 g/dL (P < .0002). No changes in clinical or laboratory variables that could be ascribed to anemia were detected.
Normocytic-normochromic anemia of unknown cause is encountered infrequently in clinical practice and is found mainly in older patients. The evaluation should be noninvasive to exclude correctable causes of the anemia. Bone marrow examination is only rarely contributive in this setting. The prognosis of these patients is excellent.
正细胞正色素性贫血常见于慢性疾病患者。病因不明的正细胞正色素性贫血的发病机制、流行病学及临床特征尚未完全明确。我们评估了骨髓检查的作用以及“特发性”正细胞正色素性贫血患者的临床病程。
正细胞正色素性贫血患者按照预定方案进行无创评估。对那些贫血原因不明的患者进行骨髓穿刺和活检。之后每隔3至6个月对他们进行随访。
检测到31例（23例女性和8例男性）“特发性”正细胞正色素性贫血患者（平均血红蛋白浓度为10.0±0.6 g/dL）。没有患者有与贫血相关的症状。进行了29次骨髓穿刺和21次活检。各有1例患者发现缺铁和轻度骨髓纤维化。其余骨髓检查均正常。在15.5±10.3个月的随访期间，血红蛋白水平略有上升至10.9±1.0 g/dL（P <.0002）。未检测到可归因于贫血的临床或实验室变量的变化。
病因不明的正细胞正色素性贫血在临床实践中很少见，主要见于老年患者。评估应采用无创方法以排除可纠正的贫血原因。在这种情况下，骨髓检查很少有帮助。这些患者的预后良好。
