肝硬変症鉄代謝障害時の赤芽球超微形態

抄録

Erythroblasts in patients with liver cirrhosis were electron microscopically studied by vertically cut sections of the buffy coat of the aspirated bone marrow, sideroblasts distributed from the top to the bottom of which were evaluated as a percentage of all erythroblasts present. 12 patients, six of whom were alcoholic, had percentages of abnormal sideroblasts with iron deposited in the mitochondria ranging from 5% to 80%, in whom, however, counts of ringed sideroblasts in ordinary smear specimens with Prussian blue staining were not accounted for up to 1%. Namely, the intramitochondrial iron studies in sideroblasts of cirrhotics have produced conflicting results. This difference is understood to result from that the intramitochondrial iron deposits are toosmall for resolution limit ability of the light microscope and optically invisible. This optically invisible iron probably plays to diminish ringed sideroblast ratios. All of non-alcoholic patients detected abnormal sideroblasts had anemia (6 cases). Despite no anemia, positive cases of abnormal sideroblasts were all alcoholic (4 cases). Correlation of red cell indices, serum iron, total iron binding capacity, folic acid or ferritin, and the recognition of abnormal sideroblasts was not seen. Although ringed sideroblasts are scanty in number or absent and further studies are needed, this sideroblast seems to represent a morphologic evidence of iron metabolic abnormality in cirrhotics.