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Volume 30, Issue 2
Displaying 1-21 of 21 articles from this issue
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—The Differentiation Induction Effect in vitro and in vivo—Tsuyoshi NAKAMAKI, Akiko SAKASHITA, Motoharu SANO, Ken-ichiro HINO, Ka ...1989 Volume 30 Issue 2 Pages 149-157
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe effects of glucocorticoid on the differentiation of myeloid leukemia cells were examined.
Dexamethasone at 10-6M or 10-7M revealed marked effects not only on leukemic blasts' survival but also on its' differentiation in vitro. In 10 of 17 cases of myeloid leukemia, the obvious morphological and functional differentiation induction effects were observed in vitro. The direction of differentiation were differed in leukemia cell lineage and in cases.
Granulocytic differentiation in M2 cells, mono-macrophage differentiation in M5 cells and either granulocytic or monocytic differentiation in M4 cells were induced.
A AML (M2), it's leukemia cells were induced into granulocytic pathway by dexamethasone in vitro, was treated with prednisolone (40 mg per day)·Ara-C (15 mg per day). The increase in peripheral leukocyte count and the decrease in immature cells were observed simultaneously. The peripheral leukocytes mainly consisted of intermediate forms of granulocytes and Pelger-Huët like neutrophiles probably originated from leukemia cells. After that course, abnormal clone was eliminated from bone marrow.
A AMoL, it's leukemia cells were induced into macrophage like cells completlely by dexamethasone in vitro, was treated with prednisolone (30 mg per day) and complete remission was obtained without passing through a hematological nadir. It is indicated that anti-tumor effects of glucocorticoid on myeloid leukemia cells are closely related to it's differentiation inducing effect and glucocorticoid can be used as the drug intending for the differentiation induction therapy of acute myeloid leukemia.View full abstractDownload PDF (1210K) -
Heiwa KANAMORI, Hiroko MIYASHITA, Takashi MURATA, Yoshimi HASHIMOTO, H ...1989 Volume 30 Issue 2 Pages 158-163
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSSepsis is one of the important complications on the treatment of severe hematological diseases. In this report, we analyzed sepsis in 309 patients with hematological diseases who were admitted to the First Department of Internal Medicine of Yokohama City University Hospital from 1979 to 1986.
Positive blood culture were found in 17.8% (55/309 cases) and total positive cases were 73 including recurrent patients. Positive rate by underlying diseases was 30.3% in acute leukemia, 20.8% in chronic myelocytic leukemia, 17.2% in aplastic anemia, 8.0% in multiple myeloma, 6.0% in malignant lymphoma and 6.5% in others. The organisms causing sepsis were as follows; gramnegative bacilli 56.4%, grampositive organisms 34.6%, fungus 6.4% and anaerobic bacteria 2.6%. Pseudomonas aeruginosa was found in 19.2%. The mortality rate of patients with sepsis was 34.2% (25/73 cases). The significant prognostic factors in patients with sepsis were the degree of neutropenia, duration of neutropenia (500<μl), the spieces of organisms, simultaneuos complication with shock and the site of other infections.View full abstractDownload PDF (461K) -
Shosaku NOMURA, Tetsuji SOGA, Mutsumasa YANABU, Masahiko SUZUKI, Koji ...1989 Volume 30 Issue 2 Pages 164-168
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe investigated platelets and plasma from patients with idiopathic thrombocytopenic purpura (ITP) to elucidate the antigenic determinants at which their autoantibodies are directed, and studied the relationship between anti-platelet antibody and platelet volume. We used flow cytometry to detect platelet-associated IgG (PAIgG), C3 (PAC3), IgM (PAIgM) and platelet volume, and also to determine the binding rate of monoclonal anti-platelet antibodies in patients with ITP. The following results were obtained.
1. Both anti-GPIIb/IIIa autoantibodies (21 of 71 patients) and anti-GPIb autoantibodies (3 of 71 patients) were found in ITP.
2. The decrease in platelet count in patients without anti-GPIIb/IIIa autoantibodies was significant.
3. The increase in platelet volume was found more frequently in patients with a platelet count less than 50,000 and in untreated patients.
4. There was a positive correlation between the platelet volume and PAIgM in patients with a platelet count less than 30,000 and high levels of PAIgM.View full abstractDownload PDF (389K) -
Norio ASOU, Hitoshi SUZUSHIMA, Noriyuki HAMASAKI, Junji GOTO, Michihir ...1989 Volume 30 Issue 2 Pages 169-174
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSSixteen adults with acute myelogeneous leukemia (AML) in relapse or refractory to conventional therapy were treated with AB-Triple V therapy. This regimen consists of aclarubicin, bephenoyl cytosine arabinoside, etoposide, vincristine, and vinblastine or vindesine. Patients who obtained complete remission (CR) were then given monthly three courses of AB-Triple V therapy, and further courses of AB-triple V therapy every three months. Eleven of the 16 patients entered CR, three were no response, and two died early after initial AB-Triple V therapy. Among 11 patients who achieved CR, 7 are alive and in CR during 1 to 13 months, one died of hepatic failure, and three patients died of infection in CR. Systemic arthralgia following the administration of vinblastine were frequently observed. These results indicate that this salvage therapy are useful for relapsed or refractory AML. Therefore, the role of this combination chemotherapy as a part of the initial postremission therapy needs to be evaluated.View full abstractDownload PDF (434K) -
Seiji KOJIMA, Minoru FUKUDA, Keizo HORIBE, Takaharu MATSUYAMA, Kunihik ...1989 Volume 30 Issue 2 Pages 175-180
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThirty two patients with hematologic malignancies and solid tumors were treated with intensive theray and autologous bone marrow transplantation. In nine out of 32 patients, it took more than 50 days to achieve a sustained platelet count of 50,000/μl or greater. Significant associations with poor platelet recovery were found for patient age, diseases, period of cryopreservation, the kinds of eradicative therapy and in vitro purging. But most of these factors overlapped each other in the same patients. No correlation was found between platelet recovery and number of cells or CFU-GM infused.View full abstractDownload PDF (457K) -
Kazuyuki SHIMIZU, Kazuo HARA, Kazunori OHNISHI, Akira KUNII1989 Volume 30 Issue 2 Pages 181-184
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAdequacy of applying Ann Arbor classification and TNM classification to evaluate extent of disease in extranodal lymphoma was assessed in patients with nasal and paranasal lymphoma.
Ann Arbor classification proposed to evaluate extent of Hodgkin's disease was not considered to be good at assessing extranodal local lesions. TNM classification was superior to Ann Arbor classification in terms of the correspondence with survival. Patients with nasal and paranasal lymphoma of T3 and T4 stage (TNM classification) were prone to develop bone marrow and CNS spread.View full abstractDownload PDF (327K)
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Junko KATO, Kenshi SUZUKI, Hitoshi NAKAGAWA, Hidetoshi ENOMOTO, Tamiko ...1989 Volume 30 Issue 2 Pages 185-192
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSMany cases of familial aggregation of lymphoproliferative malignancy have been reported. But familial aggregation of non-Hodgkin lymphoma is less frequent than Hodgkin's disease, Burkitt's lymphoma, and adult T-cell leukemia.
Here we report familial B-cell lymphomas occurring in a mother and her daughter at the same time. The daughter (43 years old) was admitted because of fever. She died of a rapidly progressive neurological disturbance. The mother (75 years old) was admitted because of fever and pleural effusion, and then died with a complication of cryoglobulinemia. The histological findings of their lymph nodes revealed diffuse lymphoma, medium-sized cell type, with B-cell phenotype and mixture of cleaved and non-cleaved nuclei. They had no common chromosome abnormalities, while they shared HLA-A 2, B 35, and Cw 3 antigen. Viral infection was not identified, by routine serological test and electronmicroscopic study.View full abstractDownload PDF (1243K) -
—Possible Existence of a New Clinical Entity Originating from the Third Lineage of Lymphoid Cells—Nobutaka IMAMURA, Yoichiro KUSUNOKI, Kenji ODA, Kazuhiro ABE, Hiroo DO ...1989 Volume 30 Issue 2 Pages 193-201
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe morphologic, immunologic, genotypic, and functional properties of peripheral blood and bone marrow cells or cultured cells from two patients with a clinically aggressive non T, non B natural killer cell lymphoma/leukemia (ANKL/L) were described. The leukemic cells possessed medium to large granules in the cytoplasm, antigens against CD 38, CD 2, OKIal, and NKH-1 (N 901) monoclonal antibodies on their cell-surface, and also showed a high natural killer (NK) activity. In addition, these ANKL/L belonged to neither T-nor B-cell lineage, proved by studying clonal gene rearrangement for the Tβ and Tγ receptor, and immunoglobulin.
After we compared and investigated them with 9 cases of ANKL/L reported in other institutions, concerning immunophenotype, genotype and function, we reached the conclusion that the existence of ANKL/L originating from the third lineage in lymphoid cells is an obvious fact, suggesting this new clinical entity. It is important that all patients who have this type of a clinical disorder be diagnosed accurately at an early stage since early splenectomy may be of some clinical value in view of the fact that there is no effective form of therapy at present.View full abstractDownload PDF (932K) -
Ken SUZUKI, Hisako UTSUMI, Kou YAMAMOTO, Takashi KAMIYAMA, Toshiya SUZ ...1989 Volume 30 Issue 2 Pages 202-206
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 60-year-old man with a one-year history of agnogenic myeloid metaplasia was admitted to the hospital because of fever and a skin eruption. He had fever, anemia, hepatosplenomegaly, and a raised painful erythematous plaque in the face. The same kind of skin lesion developed thereafter at a venipuncture site in the left forearm. Bacterial cultures were negative. There was no response to antibiotic treatment. A biopsy specimen of the skin lesion revealed a dense dermal infiltration with mature neutrophils. A diagnosis of Sweet's syndrome was made. Fever and skin eruptions responded rapidly to prednisolone (PSL). Although the disease frequently recurred on rapid tapering of PSL, skin lesions cleared without scarring on a prolonged course of PSL. Four months after withdrawal of PSL, Sweet's syndrome recurred. A high dose PSL was given without benefit. He died of disseminated candidasis.View full abstractDownload PDF (739K) -
Eizaburo SUEOKA, Yoshinori SHIMAMOTO, Kazutoshi ONO, Hideto YAMAGUCHI, ...1989 Volume 30 Issue 2 Pages 207-210
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 69-year-old man was admitted due to chronic subdural hematoma. He had lymphadenopathies in the neck. The diagnosis of non-Hodgkin lymphoma (diffuse, large, B cell type) was made by a cervical lymph node biopsy. The renal failure by obstruction of the urinary tract developed gradually, and the tumor cells were found by urinary cytodiagnosis. He was treated immediately with chemotherapy. After the treatment, the urine volume increased and the general conditions improved.
It was indicated from this case that the urinary cytodiagnosis is useful for the detection of urinary tract infiltration by lymphoma cell. The urinary cytodiagnostic abnormalities in patients with non-Hodgkin lymphomas were discussed from the literature, including this case.View full abstractDownload PDF (376K) -
Tomihiro WATANABE, Sumitada OKAMOTO, Hideo NAKAMURA, Naoki SADAMORI, K ...1989 Volume 30 Issue 2 Pages 211-215
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of Burkitt's type of acute lymphoblastic leukemia (FAB L3) in an 80-year-old male patient is reported.
At the time of diagnosis, 74% of the bone marrow cells were lymphoblastoid cells, which were large and homogeneous in size, and whose cytoplasm was abundant and intensely basophilic containing many vacuoles. λ-light chains were detected as surface immunoglobulin (Ig), but not heavy chains or κ-light chains. Epstein-Barr (EB) viral genome was detected in the cultured bone marrow cells by spot hybridization method. Chromosomal banding studies of bone marrow cells revealed t(8;22)(q24;q11) in all the 18 metaphases examined. This translocation brings the Ig λ-light chain gene on chromosome 22q11 to chromosome 8q24 where the c-myc proto-oncogene is localized, which is thought to be closely associated with the leukemogenesis of this disorder, whereas EB viral genome is observed in African Burkitt's lymphoma. To our best knowledge, however, there have been no reported Japanese patients with L3 ALL in whom t(8;22) or EB viral genome was observed.View full abstractDownload PDF (435K) -
Hideo NAKAMURA, Tomoko SATO, Tomihiro WATANABE, Shu-ichi IKEDA, Naoki ...1989 Volume 30 Issue 2 Pages 216-221
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of therapy-related myelodysplastic syndromes (t-MDS) in 66-year-old male patient is reported.
The patient was diagnosed as having multiple myeloma in July 1983. Cyclophosphamide was given since September 1984, and melphalan was added since June 1986. Radiation therapy was not performed. Mild, slowly aggravating pancytopenia developed in July 1987. By December 1987, the hemoglobin level dropped to 6.0 g/dl, leukocytes to 2,800/μl, and platelets to 15,000/μl. At that time, 27% of the bone marrow cells were blasts and 23.3% monocytoid cells. Based on these findings, a diagnosis of t-MDS was made. He was managed by supportive care only, but the monocytoid cells increased rapidly in number and he died of pulmonary bleeding in March 1988.
Chromosomal banding studies of the bone marrow cells revealed dir ins [inv (17) (p13q21); 21] (q21;p13q22) in all the 11 metaphases examined, but chromosomes No. 5 and 7 were normal. However, Keldsen et al reported that chromosome 21q rearrangements were nonrandomly associated with t-MDS and t-acute nonlymphocytic leukemia.View full abstractDownload PDF (470K) -
Toshiyuki OHNO, Hiroshi MIWA, Hiroshi ANAZAWA, Takeshi IKEDA, Keiki KA ...1989 Volume 30 Issue 2 Pages 222-226
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report a case of a 72-year-old man with large granular lymphocyte (LGL) leukemia. Immunophenotypical analysis of the abnormal cells showed the following results: CD 2+, CD 3+, CD 4+, CD 8-, CD 11+, CD 16-, Leu 7+. These cells had natural killer (NK) activity, responded to PHA and recombinant interleukin-2 (rIL-2), and showed neither helper nor suppressor function in B-cell differentiation. Molecular genetical analysis showed monoclonal rearrangement of T-cell receptor β-chain gene, indicating they are of T-cell origin. These findings provide information on biological characteristics of normal CD 4+, Leu 7+ cells.View full abstractDownload PDF (421K) -
Tetsuya TSUKADA, Kazuhiko KOBAYASHI, Noriko OTSUJI, Takeshi IKEDA, Nao ...1989 Volume 30 Issue 2 Pages 227-231
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA spontaneous complete remission for one month duration was obrerved in a 54-year-old female with acute myeloid leukemia. She had no documentation of apparent infection and blood transfusions, although they were ordinarily associated with spontaneous remission.View full abstractDownload PDF (523K) -
Masuko TAGAWA, Kiyoharu TOKUNAGA, Kazutaka KURIYAMA, Itsuro JINNAI, Yo ...1989 Volume 30 Issue 2 Pages 232-238
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of AML (M 4) with t(6;11) showed recovery to myelodysplastic syndrome (MDS)-like bone marrow after one course of DCMP regimen. Dysplastic changes of three cell-lineages were observed and micromegakaryocytes were markedly increased in number. Recovering hematopoiesis was incomplete. During MDS-like phase, t(6;11) disappeared, reverting to normal karyotypes. Low dose ara-C regimen did not show any effect. AML soon relapsed with reappearance of t(6;11). MDS-like abnormal hematopoiesis has recently been reported to occur after remission induction therapy or at the time of relapse. G-6PD isozyme study revealed in a remission case of AML that hematopoiesis still consisted of abnormal clone in spite of karyotypic normalization. The abnormal hematopoiesis observed in our case can be referred to such a clonal disorder predominating after disappearance of blastic component of AML. It seems important to reveal what proportion of de novo AMLs shows such an abnormal hematopoiesis and to establish suitable therapeutic approach.View full abstractDownload PDF (642K) -
Ikuo MIURA, Keiko HASHIMOTO, Tamio NISHINARI, Sumiko HAMANAKA, Akira B ...1989 Volume 30 Issue 2 Pages 239-244
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 26 year-old man was diagnosed as having acute monocytic leukemia (M5b: FAB classification) associated with inv (16)(p13q22). Remission induction therapy showed good results, but two years later, he complained visual blurring and revealed right papilledema. Lumbar puncture showed leukemic cell infiltration. Irradiation to the orbita, intrathecal injection of MTX and Ara-C, until the cerebrospinal fluid cleared of leukemic cells, and chemotherapy were performed. One month later, he also complained visual blurring and left papilledema was found. After whole brain irradiation, intrathecal injection and chemotherapy, papilledema disappeared. Then, one year later, paralysis of right lower extremity appeared and brain computed tomography (CT) demonstrated tumor with increased density in the left frontal lobe, which enhanced with contrast material. Analysis of spinal fluid demonstrated abnormal cells. He was treated radiation therapy combined with intrathecal MTX and Ara-C. The patient survives currently three years after diagnosis and remains free of central nervous system disease. Because the patients with inv (16) have a high incidence of CNS involvement, they should be monitored closely with periodic lumber punctures.View full abstractDownload PDF (1043K) -
Terushi NASU, Junichi AKIMOTO, Akinori WATANABE, Takeshi MINAMI, Takum ...1989 Volume 30 Issue 2 Pages 245-250
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of AML accompanied by HTLV-I associated myelopathy (HAM) is reported. A 37-year-old woman was admitted to our hospital in April 1985 because of severe anemia, general malaise and fever. On admission, anemia, thrombocytopenia and leukocytosis consisting of 32% myeloblasts and 6% promyelocytes were noted. A bone marrow study revealed marked myeloid hyperplasia, and a diagnosis of acute myelogenous leukemia (M2) was made. In order to improve the patient's severe anemia and thrombocytopenia, a large amount of blood transfusion was applied at once. Thereafter BHAC-DMP therapy was commenced resulting in complete remission 3 months after initiating chemotherapy. Hematological improvement has continued (as of May 1988).
In June 1986 the patient showed a gait disturbance of slowly progressive course. Neurological examination revealed hyperactive knee and ankle jerks with a positive Babinski's sign, and foot clonus were also noted bilaterally. Sphincter impairment was detected. A CSF sample contained slight pleocytosis with some abnormal lymphocytes similar to those found in adult T cell leukemia. Antibodies to HTLV-I were found in the CSF and serum by EIA method. According to these findings we diagnosed the patient's illness as HAM, referring to the new clinical entity named by Osame. This patient had undergone a blood transfusion 14 months before the onset of this myelopathy, therefore the transmission of exogenous antigens through blood transfusion may be the cause of HAM. Corticosteroid pulse treatment was administered and striking improvements countering gait disturbance resulted in this patient.View full abstractDownload PDF (494K) -
Hiroyuki TAKAHIRA, Hiroshi IDEGUCHI, Jouji HIRATA, Junji NISHIMURA, Ha ...1989 Volume 30 Issue 2 Pages 251-255
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 33-year-old female was admitted to St. Marianna University hospital in April 1983 for the purpose of examination for leukocytosis. Physical examination revealed a marked splenomegaly. The white cell count was 174×109/l. The hemoglobin was 9.0 g/dl and the platelet was 790×109/l. Microscopical examination of aspirated specimen of bone marrow revealed hypercellularity with granuloid hyperplasia. The chromosomal analysis of bone marrow cells showed Philadelphia chromosome in all metaphases analyzed. The neutrophil alkaline phosphatase activity was reduced. A diagnosis of CML was made. She was treated with busulfan in a dose of 2 mg/day until the white cell count was 14.5×109/l. She has been followed without any therapy and clinical remission state has been continued. In April 1985, the chromosomal analysis of bone marrow cells revealed the recovery of normal karyotype hemopoiesis in 57% of metaphases analyzed. These findings of this case suggest that some of Ph1-positive cells may reduce their growth advantage over normal cells without any bone marrow hypoplasia.View full abstractDownload PDF (379K) -
Hiroshi FUJII, Taira MAEKAWA, Tadashi KANOH, Tadashi OHNAKA, Kazuhiro ...1989 Volume 30 Issue 2 Pages 256-261
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAn autopsy case of primary cutaneous plasmacytoma with very unusual extensive skin involvement resulting in death 9 months later, was reported.
A 75-year-old female was admitted to our hospital in November, 1985 because of an enlarging skin nodule on the right neck of 5 month's duration. The nodule was a 5×7×4-cm, firm and mobile mass. Light- and electron-microscopic studies of its biopsy specimen revealed a cutaneous plasmacytoma which was composed of dense aggregates of plasma cells. Cytogenetic study on the biopsy specimen revealed hypotetraploid and structural abnormalities such as 7q+, 11q+ and 20q+. After radiotherapy, the right neck nodule became smaller, but subcutaneous indurations with erosions extended to the surrounding skin. The biopsy specimen of these skin lesions microscopically revealed massive infiltrations of plasma cells in the dermis. The PAP method revealed a definite evidence of monoclonal kappa light chain production by these cells. 3H-thymidine were incorporated in 5.6% of the plasma cells. The skin lesions were refractory to chemotherapy and gradually extended. The clinical course showed a progressive one leading to presistent deterioration and she died in August, 1986. Repeated examinations including immunoelectrophoresis of serum and concentrated urine, bone marrow aspirations and skeletal x-ray films, excluded the diagnosis of myeloma. At autopsy, massive infiltrations of plasma cells in the skin of chest wall and neck, small metastatic tumors in the liver and bilateral axillary lymph nodes were found, but there was no evidence of bone marrow involvement.View full abstractDownload PDF (1071K) -
Manabu HASHIMOTO, Iwao SEKIKAWA, Kiyoshi SAITO, Seiichi HORIE, Taijiro ...1989 Volume 30 Issue 2 Pages 262-265
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 58-year-old man was admitted to our hospital because of low grade fever and purpura in September. 1987. On admission, his bone marrow aspiration showed nucleated cell count of 48×104/mm3 with 94.6% of promyelocyte-like leukemic cells. A diagnosis of acute promyelocytic leukemia was made and he was treated with high dose cytosine arabinoside (HDAra C). After this therapy, serum bilirubin, especially direct bilirubin was increased and hyperbilirubinemia was progressed with normal transaminase levels. He had complicated by pneumonia and died of respiratory failure. Autopsy revealed only cholestasis in the liver with neither hepatic cell necrosis nor cell infiltration. This case was though to be a rare case with cholestatic liver injury due to HDAra C.View full abstractDownload PDF (536K) -
Kesashi AONUMA, Fumio MOROHASHI, Tatsutoshi NAKAHATA, Atsushi KOMIYAMA ...1989 Volume 30 Issue 2 Pages 266-270
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report a Childhood case of hereditary spherocytosis (HS) first diagnosed upon the development of aplastic crisis. A 6-year-old boy presented with fever and anemia. Although there was neither icterus nor splenomegaly at first, mild icterus and splenomegaly gradually developed with improvement of anemia. The diagnosis of HS was made on the basis of the presence of numerous spherocytes on the peripheral smear, increased osmotic fragility and the auto-hemolysis test result. The severe anemia in the early course with a marked decrease in the bone marrow erythroid cells and the absence of icterus and splenomegaly indicate that it was due to aplastic crisis. In the virological study, anti-human parvovirus (HPV) antibody titers were increased: the values of anti-HPV IgM were high and those of anti-HPV IgG were suddenly elevated. We thus considered that this HS case developed aplastic crisis by HPV infection.View full abstractDownload PDF (367K)
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