体位性低酸素血症をともなったGaisböck症候群の1例

A case of Gaisböck syndrome with postural hypoxemia

　1950年Gaisböckは，脾腫のない，高血圧をともなう，肥満した多血症の症例をまとめて報告した。これを基礎に1950年代^1）から，検査法の進歩を背景として，relative, pseudo, stress，あるいはspurious polycythe—miaなどと呼ばれる多血症として再定義されてきている^2,3）。

　我々は相対的多血症，肥満，高血圧，不安緊張感，高尿酸血症を示し，再定義されているGaisböck症候群^2,3）と考えられる症例を経験した。この症例には，臥位で著しく増悪する低酸素血症が確認され，多血症との関連が考えられた。

A case of redefined Gaisböck syndrome was reported, who had relative polycythemia, obesity, hypertension, excessive nervousness or tension,and hyperuricemia. The case was a 46-year-old male and his obesity rate was 166%. He showed hypoxemia which grew worse in the supine position. Postural hypoxemia was thought to happen mainly due to unevenness of ventilation which was interpreted by the correlation between closing volume and FRC level. Expiratory reserve volume decreased from 1100 ml in a seated position to 250 ml in the supine position, whereas closing volume changed only 100 ml from 600 to 700. The increase of erythropoietin which was induced by hypoxemia was also con-firmed. So the value of total red cell volume and plasma volume were compatible with relative polycythemia, but secondary polycythemia was not ruled out definitely.