不応性貧血の一症例にみられた Th-polyagglutination

We report a case of Th-polyagglutination associated with refractory anemia.The patient was a 16-year-old boy admitted to our hospital with complaint of anemia without infection and history of blood transfusion. He had leukopenia and anemia in peripheral blood, prominent hyperplasia and morphological abnormality of erythoid in bone marrow, and was diagnosed as refractory anemia.The presence of Th-polyagglutination of the patient was found in the course of blood transfusional examination. The nature of this antigenisity of erythrocyte and enzyme acitvity were analysed with the following results:1) Identified anti-I antibodies in the serum.2) The enhancement of i antigen and diminished I antigen along with the depressed in H antigen activity on the erythrocytes of the patient.3) Erythrocytes agglutination with 40/100 AB group sera of healthy donor and reaction with lectines (Arachis hypogaea, Vicia cretica). The erythrocyte treated with papain did not react with Arachis hypogaea. The phenomenon suggested that Th was the original receptor of plyagglutination.4) The presence of anti-T, anti-Tn and anti-Tk in the serum.5) The erythrocytes agglutinated with 0.05% hexadimethrine bromide.6) The analysis of glycosidase showed β-D-glucosidase, β-N-acetyl-D-glucosaminidase, β-N-acetyl-D-galactosaminidase, α-D-galactosidase, α-L-fucosidase 13.2 unit, 15.4 unit, 16.2 unit, 11.2 unit and 9.8 unit, respectively, and no statistically significant difference compared with control serum of the healthy donor.The expression of Th receptor in this patient was thought to be due to the abnormal erythropoiesis of refractory anemia, because there was of no clinical and laboratory evidence of bacterial infection, and positive Th-polyagglutination peristed during the study period of five months.