症例
In vitroでジフェニルヒダントインによる骨髄ヘム合成抑制を証明した赤芽球癆の1例
1982 年 23 巻 9 号 p. 1446-1452
詳細
1982 年 23 巻 9 号 p. 1446-1452
A 55-year-old man who had undergone a craniotomy developed pure red cell aplasia (PRCA) during treatment with diphenylhydantoin (DPH) and phenobarbital. This anemia rapidly improved after discontinuance of the drugs. An in vitro study using the Krantz's method was carried out to observe the influence of DPH, lymphocytes and serum on heme synthesis of the bone marrow erythroblasts. The heme synthesis was determined by the incorporation of radioactive iron into heme as an indicator. The following results were obtained: 1) Heme synthesis of the patient's erythroblasts was remarkably inhibited by DPH at a concentration of 25 μg/ml. 2) His serum or lymphocytes did not produce any influence on the inhibition of heme synthesis by DPH. These results suggest that a possible cause of PRCA was a damage of patient's bone marrow erythroblasts by DPH because of their increased susceptibility to the drug.
