演題詳細

一般口演 / Oral Session

一般口演 74 (Oral Session 74) :貧血の臨床

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日程
2013年10月13日(日)
時間
08:45 - 09:45
会場
第4会場 / Room No.4 (さっぽろ芸文館 3F 黎明)
座長・司会
亀岡 淳一 (Junichi Kameoka):1
1:東北大学 血液・免疫病学分野
 
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The causes of macrocytic anemia in 933 patients: MCV 115 as a marker of authentic macrocytic anemia

演題番号 : OS-3-11

亀岡 淳一 (Junichi Kameoka):1、高橋 奈津子 (Natsuko Takahashi):1、高橋 直人 (Naoto Takahashi):2、玉井 佳子 (Yoshiko Tamai):3、村井 一範 (Kazunori Murai):4、横山 寿行 (Hisayuki Yokoyama):5、野地 秀義 (Hideyoshi Noji):6、本間 りこ (Riko Honma):7、遠宮 靖雄 (Yasuo Tohmiya):8、加藤 裕一 (Yuichi Kato):9、張替 秀郎 (Hideo Harigae):1、石田 陽治 (Yoji Ishida):4、澤田 賢一 (Kenichi Sawada):2

1:Department of Hematology and Rheumatology, Tohoku University, Sendai, Japan、2:Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine、3:Division of Blood Transfusion Medicine, Hirosaki University Hospital、4:Department of Hematology/Oncology, Internal Medicine, Iwate Medical University、5:Department of Hematology, Sendai Medical Center、6:Department of Cardiology and Hematology, Fukushima Medical University、7:Department of Hematology, Yamagata Central Hospital、8:Department of Hematology, Miyagi Cancer Center、9:Third Department of Internal Medicine, Yamagata University School of Medicine

 

Although macrocytic anemia (MCV 100 or more) is caused by various diseases such as megaloblastic anemia (MA), the percentages of etiologic diseases according to the threshold values of MCV have not been determined in a large number of patients. Here, we investigated the causes of macrocytic anemia in patients who visited the Outpatient Clinic of Hematology in Tohoku University Hospital from Apr 2002 to Dec 2012, and patients who visited the Outpatient Clinics of Hematology in eight general hospitals in the Tohoku region (belonging to the Tohoku Hematology Forum) from Apr 2011 to Dec 2012. A total of 933 patients showed MCV 100 or more. Their main causes (number of patients, %) were B12 deficiency (78, 8.4%), folic acid deficiency (12, 1.3%), alcoholism (29, 3.1%), liver diseases (57, 6.1%), MDS (178, 19.1%), aplastic anemia (58, 6.2%), hemolytic anemia (36, 3.9%), and hypothyroidism (8, 0.9%). Other unexpected causes included lymphoid malignancy (57, 6.1%), plasma cell dyscrasia (54, 5.8%), cancer (40, 4.3%), and chronic renal failure (17, 1.8%), but none of these patients had MCV exceeding 115. The number of total patients and % of MA according to the threshold values of MCV were: 140 (7, 100%), 135 (13, 92%), 130 (27, 85%), 125 (52, 75%), 120 (80, 62%), 115 (135, 48%), 110 (236, 33%), 105 (460, 19%), and 100 (933, 9%). The correlation between the threshold values of MCV and % of MA showed a linear curve (r=0.994). We propose an MCV threshold value of 115 as a marker of authentic macrocytic anemia, which comprises approximately 50% of MA and eight other diseases.

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