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(17-P1-16) 症例は46歳男性。主訴は,急性出血性胃潰瘍による失1血後8日目に自覚した左眼中心暗点。高血圧,糖尿病の既往歴はない。初診時,右眼視力O.1(1.2),左眼視力O.04(0.2)で,両眼後極部に網膜出血,軟性白斑を認めた。ヘモグロビン(Hb値)は,約2週問4.7〜9.1g/dlで推移した。胃切除後貧血は改善し,網膜出血も吸収傾向を示した。貧血性網膜症における血液像についての報告は慢性貧血に関するものが主で,急性貧血の例は少ない。急性貧血の例ではHb値が3.Og/dlや5.8g/dlの重症例でも,高血圧,糖尿病を合併した1例を除いて網膜出血はみられず,一過性貧血では網膜出血は生じにくいと考えられた。
A 46-year-old man developed acute hemorrhagic gastric ulcer followed by visual blurring in his left eye 8 days later. He had no hypertension or diabetes mellitus. Funduscopy showed hemorrhagic patches and soft exudates in the posterior retina in both eyes. He was anemic with the hemoglobin concentration fluctuating between 4.7 and 9.1 g/dl for about 2 weeks. No thrombocytopenia was present. Gastrectomy was followed by regression of anemia and retinal hemorrhage. This case illustrates that retinal hemorrhage following acute anemia is generally rare but may occur under exceptional circumstances.
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