漢方薬（小柴胡湯＋加味帰ひ湯）とメチルプレドニゾロン大量療法の併用が奏効した肝炎 再生不良性貧血症候群の１重症例

Abstract

Abstract Combined treatment with high-dose methylprednisolone and Kampoherbal medicine (Xiao-Chai-Hu-Tang and Jia-Wei-Gui-Pi-Tang) brought about a striking clinical improvement in a 24-year-old woman with severe hepatitis-associated aplastic anemia. Laboratory findings on admission were summarized as follows: granulocytes 325/μl, erythrocytes 2, 450, 000/μl, platelets 10, 000/μl, bone marrow nucleated cells 27, 000/μl, and GPT 569IU/l. Neither anti-lymphocyte globulin, high-dose methylprednisolone alone nor oxymetholone was effective on any hematological finding although intravenous administration of high-dose glycyrrhizin improved the liver dysfunction. The patient needed repeated transfusions of leukocyte-poor washed red blood cells and HLA-matched platelet concentrates for a period of 1.5 years until the hematopoietic function recovered 3 months after combined treatment with high-dose methylprednisolone and Kampo-herbal medicine. Laboratory findings on discharge were as follows: granulocytes 1, 050/μl, erythrocytes 3, 460, 000/μl, reticulocytes 100, 000/μl, platelets 47, 000/μl, bone marrow nucleated cells 118, 000/μl, and GPT 52IU/l. Six months later hematopoietic depression recurred, and this combined treatment was performed again with favorable response.