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Heinz小体の出現を伴う一過性溶血発作を呈した極低出生体重児10例の経験
熊坂 栄1, 島 義雄1, 中島 瑞恵1, 右田 真2
1葛飾赤十字産院新生児科, 東京
2日本医科大学大学院医学研究科小児医学
Acute Hemolytic Anemia in Very Low Birth Weight Infants: A Series of Cases
Sakae Kumasaka1, Yoshio Shima1, Mizue Nakajima1 and Makoto Migita2
1Department of Neonatology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo
2Department of Pediatrics, Graduate School of Medicine, Nippon Medical School
We report on 10 premature infants with acute hemolytic anemia and Heinz bodies treated from 1999 to 2007 and discuss their clinical characteristics. All patients were very low birth weight infants (mean gestational age, 27 weeks; range, 24∼30 weeks; mean birth weight, 889 g; range, 598∼1,412 g), and hemolytic anemia developed after cardiopulmonary adaptation had been achieved. Heinz body appeared an average of 20 days after birth (range, 11∼25 days), and hemolysis persisted for an average of 9 days (range, 4∼16 days) and spontaneously resolved. Hemolytic anemia and jaundice developed suddenly, during which time Heinz bodies were observed on hematologic examination. The affected infants showed refractory apnea just before the onset of hemolytic anemia.
The exact cause of these hemolytic episodes remains unclear. However, the immature antioxidant function of the red blood cell membrane against oxygen radicals was a suspected cause, because most of the infants required ventiratory managements with high concentration of supplemental oxygen.
日医大医会誌 2011; 7(1), 16-19
Key words
very low birth weight, Heinz body, hemolytic anemia, hyperbilirubinemia, newborn
Correspondence to
Sakae Kumasaka, Department of Neonatology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku Tokyo 124-0012, Japan
E-mail：kumasaka@nms.ac.jp
受付：2010年11月4日 受理：2010年12月17日 |
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