蛋白同化ステロイドで治療中，ネフローゼ症候群を併発し，急速に血液像の悪化をみた再生不良性貧血の1例

—とくに造血幹細胞およびエリトロポエチン動態よりの検討—

抄録

A seventy-year-old man diagnosed as drug-induced aplastic anemia was presented. After admission to the authors' clinic, a treatment with a large dose of anabolic steroids, oxymetholone and methenolone, was instituted for aplastic anemia. Five months later the patient suddenly developed proteinuria (up to 31 g/day), hyperlipidemia, slight hypertension and subsequent hypoproteinemia. Renal function was quite normal. No elevation of BUN and creatinine was observed. However, the degree of pancytopenia was gradually enhanced, and ferrokinetic studies revealed a markedly decreased erythropoiesis. Erythropoietin (EPO) titers both in serum and urine were markedly high at any time before and after the renal involvement, while responsiveness of bone marrow cells to EPO was rapidly decreased. It was thought that the decrease in ERC brought about the lowering of erythropoiesis.
The pathogenesis of the “nephrotic syndrome” occurred under administration of a large dose of anabolic steroid was not evident. But this brief report seems to give a warning against anabolic steroid therapy.