MDSと鑑別を要する疾患の検査所見

Laboratory findings of the diseases that should be distinguished from MDS

MDSは汎血球減少と形態異常を呈する腫瘍性造血器疾患であり，再生不良性貧血，巨赤芽球性貧血，発作性夜間血色素尿症などが代表的鑑別診断として挙げられる．症例をくまなく検討し，形態異常や遺伝子異常の有無から再生不良性貧血を，ビタミンB₁₂あるいは葉酸値から巨赤芽性貧血を，CD55，CD59陰性細胞や溶血所見の有無から発作性夜間血色素尿症を，それぞれ鑑別する．診断後の治療方針や予後に大きな違いがある疾患群であるため，慎重かつ確実な診断が必要である．

Myelodysplastic syndrome is characterized by pancytopenia and multilineage dysplasia.　Aplastic anemia, megaloblastic anemia and paroxysmal nocturnal hemaoglobinuria that show one or two of these characteristics are diseases that should be strictly distinguished from MDS.　Presence of dysplasia and genetic abnormality, serum levels of vitamin B₁₂ and folic acid, and detection of CD55/CD59 negative cells and hemolytic features are important points for making a differential diagnosis.　Since the treatment strategies and the prognosis are very different from each other, a careful and accurate diagnosis is necessary.