抄録
A 37-year-old female had been admitted to our hospital 4 times since January 1976, because of nausea, vomiting, diarrhea, numbness of her hands and feet and generalized skin pigmentation. From these findings and high levels of arsenic in her hair and nail, she was diagnosed as being involved in arsenic poisoning.
On her first and second admission, leukopenia and normocytic normochromic anemia with marked reticulocytosis were noted. This reticulocytosis suggested the existence of hemolysis. On her third admission, it was noteworthy that she had typical laboratory manifestations of ineffective erythropoiesis due to megaloblastic process, including mild pancytopenia, low reticulocyte index, increased marrow cellularity with erythroid hyperplasia and morphological evidence of megaloblastic maturation in the marrow. The serum levels of vitamin B12 and folate were within normal ranges, and the administration of vitamin B12 was not effective. On her last admission, severe pancytopenia and hypocellular marrow were noted. Since all these hematological abnormalities were regressed with the regression of other symptoms and signs, it was suggested that these hematological abnormalities including megaloblastic anemia were also caused by the arsenic poisoning.
