楕円赤血球症

一家系ならびに本邦報告例の総括と考察

抄録

A sixty-year old man presented himself with a chief complaint of upper abdominal pain which was subsequently found to be due to ascariasis and cleared completely after anthelmintic therapy. Incidental blood study showed normochromic anemia with large numbers of elliptocytary red blood cells. According to Günther's criteria, erythrocytes were classified into four different types and a percentage of each type in the patient was determined. The results were that type I (round) was 0%, type II (oval) 2.5%, type III (elliptical) 1.5% and type IV (rod shaped) 96.0% respectively. In spite of very meticulous observation on the shape of erythroblasts in varying stages of development, no significant changes were noted in the sternal marrow aspirate. Reticulocytes in the peripheral blood were all round in shape.
A total of thirteen of the fourteen members of this family were evaluated through 3 generations, and six were found to have positive elliptocytes. The mode of inheritance in these six kindreds could be explained as a simple or autosomal dominant.
In 1904, for the first time in the world, Dresbach reported one case of elliptocytosis. In Japan, it was in 1938 when the first case was described by Iwao. Since then, forty-two families with this hereditary disease were reported with a totaling number of 152 patients. Symptomatic or transient elliptical erythrocytosis was described in other four reports and another report was concerned with the degrees of elliptical changes seen in normol human erythrocytes.