Fifteen years old, male. Concomitant presence of the anomaly of the occipital bone and upper cervical spine, and the growth disturbance due to splenomegaly with the iron deficiency anemia was recognized. Anomaly of the bones were consisted of platybasis, occipitalization of the atlas, partial defect in the third cervical vertebrae and spina bifida of the lumbars. Each of these abnormalities seemed to be a chain of events and presumably congenital in nature. It appears probable that the growth disturbance firstly noticed his school age, and his statur was short and he always received poor scholarly attainments.
On admission, his height was only 146.8cm, and his facial expression had a characteristic childly appearance against the age. Axillary hair and pubic hair were not found, and the penis and the scrotum appeared to be child's one. The breaking of voice was also not yet occurred at that time. The impaired development of the patient seemed to have close causual relation to the splenomegaly was strongly suggested. Spleen was palpable one finger breadth under the costal margin.
Rather marked degree of iron deficiency anemia was found; it was suggested that this anemia of the patient also had a close relationship to the splenomegaly. The anemia was reacted successfuly with the iron therapy, but it tended to recur after discontinuation of the iron administration. After the splenectomy was performed, both hematopoietic and growth disturbances were recovered fairly rapidly, and brighten the personality as it was before. It seemed to us, therefore, that the growth disturbance of the patient, as well as the anemia, was proved to have close connection with the splenomegaly.
It is possible to understand that the abnormalities of the bones and the splenomegaly existed together quite incidentally. However, if there is apossibility to develope the splenomegaly in utero in this case, it can be conceivable that a certain morbidity of the mother left behind on one side the splenomegaly, and on the other side the abnormalities of the bones.
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