THE BLOOD PICTURES OF THE BONE MARROW IN SUBACUTE BACTERIAL ENDOCARDITIS

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  • Takei Hiroshi
    Department of Internal Medicine, School of Medicine, Keio University

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  • 亞急性細菌性心内膜炎の骨髓像
  • アキュウセイ サイキンセイシン ナイ マクエン ノ コツズイゾウ

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To define the causes and developments of anemia in infektion, the blood pictures of the bone marrow (chiefly that of sternum) in 29 cases with subacute bacterial endocarditis were studied since 1951 during the process of this disease, and the following results were obtained:<br>1) Formation arrest of myeloid series due to decrease in myeloblasts was noticed. The reaction of neutrophilic granulocytes showed a slight hyperplasia and shift to the left (immaturity). This shift was much remarkable in cases with peripheral leukocytosis. Increase in neutrophilic granulocytes get alleviated to less than normal level after administration of antibiotics.<br>2) Plasma cells showed a significant increase above the normal value and had a positive correlation with γ-globulin of serum protein fraction.<br>3) No evidence of decrease in erythroid series was recognized, exclusive of a few special cases with hypoplasia. Instead, hyperplasia was seen when antibiotics were administered. In erythroid series, similar to neutrophilic granulocytes, there occured the shift to the left, and the more anemia is evident, the more this shift is remarkable.<br>4) Accordingly the granulocytic-erythrocytic ratio did not show a significant difference from the normal value.<br>5) In some cases of s. b. e., the blood pictures of the bone marrow revealed resembling myelograms to such blood disorders as iron deficiency anemia, aplastic anemia, and chronic myeloic leukemia, but differential diagnosis might be possible after recognition of essential difference.<br>6) The isolation rate of the causative organisms by the blood culture of the bone marrow was lower than the arterial or venous blood.

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