Key result
Spur cell anemia and chronic DIC in severe liver cirrhosis improve as hemolysis decreases.
Case Report (n=1)
No
A case report detailing the clinical course of a patient with liver cirrhosis who developed spur cell anemia and chronic DIC triggered by hemolysis.
May alert clinicians to monitor DIC in spur cell anemia; hypothesis-generating and leaves causal link open.
46歳男性でアルコール多飲歴のある肝硬変患者に持続する溶血性貧血と出血傾向の出現をみた.光顕ならびに走査電顕による観察で,末梢血における赤血球の有棘化を認めた.赤血球の酵素活性には異常はなかったが,血清lecithin: cholesterol acyltransferase (LCAT)の活性低下や赤血球膜のcholesterolとphospholipidとの比(C/P ratio)の上昇を認めspur cell anemiaと思われた.溶血時に出血傾向と共に凝固因子低下,線溶亢進の所見を認め,131I-Fibrinogenの半減期は短縮していた.出血傾向の原因として高度の肝網内系機能不全状態に溶血がtriggerとなったchronic disseminated intravascular coagulopathy (chronic DIC)が考えられた.溶血性貧血とDICは各々5カ月と2カ月の経過で改善し,入院後1年を経て末梢血中の spur cellは減少している.
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正行 et al. (1978) conducted a case report in Liver cirrhosis, spur cell anemia, chronic DIC (n=1). Severe liver cirrhosis and heavy alcohol intake was evaluated. A 46-year-old male with severe liver cirrhosis developed spur cell anemia and chronic DIC, which improved as hemolysis decreased over a one-year follow-up.
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