(肝臓や腎臓障害時に増殖する異常赤血球)有棘赤血球

WordNet

an abnormal red blood cell that has thorny projections of protoplasm

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/03 16:59:53」(JST)

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For the stellate cells found on the hyphae of fungi of the genus Stropharia, see Acanthocyte (mycology).

Acanthocytosis in a patient with abetalipoproteinemia.

Acanthocyte (from the Greek word acantha, meaning 'thorn'), in human biology and medicine, refers to a form of red blood cell that has a spiked cell membrane, due to abnormal thorny projections.^[1]^[2] A similar term is spur cells.

Acanthocytes have coarse, irregularly-spaced, variably sized crenations, resembling many-pointed stars. They are seen on blood films in, among others abetalipoproteinemia,^[3] liver disease, chorea acanthocytosis, McLeod syndrome and several inherited neurological disorders, such as neuroacanthocytosis,^[4] anorexia nervosa, infantile pyknocytosis, hypothyroidism, ideopathic neonatal hepatitis, alcoholism, congestive splenomegaly, Zieve syndrome, and chronic granulomatous disease.^[5]

Usage[edit]

Spur cells may refer synonymously to acanthocytes,^[6] or may refer in some sources to a specific subset of 'extreme acanthocytes' that have undergone splenic modification whereby additional cell membrane loss has blunted the spicules and the cells have become spherocytic ('spheroacanthocyte'), as seen in some patients with severe liver disease.^[7]

Acanthocytosis can refer generally to the presence of this type of crenated red blood cell, such as may be found in severe cirrhosis or pancreatitis,^[6] but can refer specifically to abetalipoproteinemia, a clinical condition with acanthocytic red blood cells, neurologic problems and steatorrhea.^[8] This particular cause of acanthocytosis (also known as abetalipoproteinemia, apolipoprotein B deficiency, and Bassen-Kornzweig syndrome) is a rare, genetically inherited, autosomal recessive condition due to the inability to fully digest dietary fats in the intestines as a result of various mutations of the microsomal triglyceride transfer protein (MTTP) gene.^[9]

Pathophysiology[edit]

Acanthocytes arise from either of two mechanisms. Alterations in membrane lipids are seen in abetalipoproteinemia and liver dysfunction. Alteration in membrane structural proteins are seen in neuroacanthocytosis and McLeod syndrome.

In liver dysfunction, apolipoprotein A-II deficient lipoprotein accumulates in plasma causing increased cholesterol in RBCs. This causes abnormalities of membrane of RBC causing remodeling in spleen and formation of acanthocytes.

In abetalipoprotinemia, there is defeciency of lipids and Vitamin E causing abnormal morphology of RBCs.

Differential diagnoses[edit]

Acanthocytosis can be seen in: Acute or Chronic Anemia, Hepatitis A,B,C; Hepatorenal syndrome, Hypopitutarism, Malabsorption Syndromes, Malnutrition^[10] In malnourishment, such as anorexia nervosa and cystic fibrosis, acanthocytosis remits with resolution of the nutritional deficiency.^[11] Acanthocyte-like cells may be found in hypothyroidism, after splenectomy, and in myelodysplasia.^[11]

Acanthocytes should be distinguished from echinocytes, which are also called 'burr cells', which although crenated are dissimilar in that they have multiple, small, projecting spiculations at regular intervals on the cell membrane.^[7]^[11] Burr cells usually imply uremia, but are seen in many conditions, including mild hemolysis in hypomagnesemia and hypophosphatemia, hemolytic anemia in long-distance runners, and pyruvate kinase deficiency.^[10] Burr cells can also arise in vitro due to elevated pH, blood storage, ATP depletion, calcium accumulation, and contact with glass.^[10] Acanthocytes should also be distinguished from keratocytes, also called 'horn cells' which have a few very large protuberances.^[11]

References[edit]

^ "acanthocyte" at Dorland's Medical Dictionary
^ Wrongdiagnosis --> Acanthocytosis Retrieved on October 12, 2009
^ Cooper RA, Durocher JR, Leslie MH (July 1977). "Decreased fluidity of red cell membrane lipids in abetalipoproteinemia". J. Clin. Invest. 60 (1): 115–21. doi:10.1172/JCI108747. PMC 372349. PMID 874076.
^ Rampoldi L, Danek A, Monaco AP (2002). "Clinical features and molecular bases of neuroacanthocytosis". J Mol Med 80 (8): 475–91. doi:10.1007/s00109-002-0349-z. PMID 12185448.
^ "Acanthocytosis". http://emedicine.medscape.com/article/954356-overview#a0101. Missing or empty |url= (help); |accessdate= requires |url= (help)
^ ^a ^b Hillman, RS; Ault, KA; Leporrier, M; Rinder, HM. (2011). Hematology in Clinical Practice (5th ed.). McGraw-Hill. ISBN 978-0-07-162699-6.
^ ^a ^b Mentzer WC. Spiculated cells (echinocytes and acanthocytes) and target cells. UpToDate (release: 20.12- C21.4) [1]
^ Longo, D; Fauci, AS; Kasper, DL; Hauser, SL; Jameson, JL; Loscalzo J. (2012). Harrison's Principles of Internal Medicine (18th ed.). McGraw-Hill. ISBN 978-0-07174889-6.
^ Haldeman-Englert, C; Zieve, D. (August 4, 2011). "Bassen-Kornzweig syndrome". Pub Med Health. National Center for Biotechnology Information, U.S. National Library of Medicine.
^ ^a ^b ^c de Alarcon PA (Nov 30, 2011). "Acanthocytosis".
^ ^a ^b ^c ^d Hoffman, R; Benz, EJ; Silberstein, LE; Heslop, H; Weitz J; Anastasi, J. (2012). Hematology: Basic Principles and Practice (6th ed.). Elsevier. ISBN 978-1-4377-2928-3.

External links[edit]

Acanthocyte: Presented by the University of Virginia
Acanthocytes at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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1. 棘状細胞（棘状赤血球および有棘赤血球）と標的細胞 spiculated cells echinocytes and acanthocytes and target cells
2. 神経有棘赤血球症 neuroacanthocytosis
3. 舞踏病の概要 overview of chorea
4. 末梢血塗抹標本の評価 evaluation of the peripheral blood smear
5. 全身疾患による外因性の非免疫性溶血性貧血 extrinsic nonimmune hemolytic anemia due to systemic disease

English Journal

In vivo genotoxicity and cytotoxicity assessment of cadmium chloride in peripheral erythrocytes of Labeo rohita (Hamilton).

Jindal R1, Verma S2.
Ecotoxicology and environmental safety.Ecotoxicol Environ Saf.2015 Aug;118:1-10. doi: 10.1016/j.ecoenv.2015.04.005. Epub 2015 Apr 16.
Cadmium chloride (CdCl2) induced genotoxicity and cytotoxicity has been assessed in the peripheral blood erythrocytes of freshwater fish Labeo rohita exposed to 0.37 and 0.62mg/L of CdCl2 in water for 100 days. The blood samples of the fish were collected at different intervals (days 1, 3, 5, 10, 15
PMID 25890049

Association of abnormal erythrocyte morphology with oxidative stress and inflammation in metabolic syndrome.

Gyawali P1, Richards RS2, Bwititi PT3, Nwose EU4.
Blood cells, molecules & diseases.Blood Cells Mol Dis.2015 Apr;54(4):360-3. doi: 10.1016/j.bcmd.2015.01.005. Epub 2015 Jan 17.
In carrying out their role of free radical scavenging, erythrocytes become damaged due to oxidation of membrane lipids and proteins. Such damage may change the morphology of the erythrocytes. The present study aims to demonstrate change in erythrocyte morphology in MetS and associate the changes wit
PMID 25616368

Fish erythrocytes as biomarkers for the toxicity of sublethal doses of an azo dye, Basic Violet-1 (CI: 42535).

Kaur K1, Kaur A1.
Microscopy and microanalysis : the official journal of Microscopy Society of America, Microbeam Analysis Society, Microscopical Society of Canada.Microsc Microanal.2015 Feb;21(1):264-73. doi: 10.1017/S1431927614013609. Epub 2014 Dec 1.
The aim of the present study was to investigate poikilocytosis in Labeo rohita (an important food fish) as an early indicator of stress due to an azo dye, Basic Violet-1 (CI: 42535). This dye was observed to be very toxic to test fish (96 h LC50 as0.45 mg/L dye). Fish were given short-term (96 h) an
PMID 25434363

Japanese Journal

肝障害と有棘赤血球の関連性

眞田久美子,後藤剛,松本眞弓,濱田文香,天野真依子,杉本昌美
医学検査 : 日本臨床衛生検査技師会誌 = The Japanese journal of medical technology 60(1), 34-40, 2011-01-25
NAID 10030458034

A useful new classification of dysmorphic urinary erythrocytes

NAGAHAMA Daisuke,YOSHIKO Kenichi,WATANABE Mikio,MORITA Yoshiki,IWATANI Yoshinori,MATSUO Seiichi
Clinical and experimental nephrology 9(4), 304-309, 2005-12-01
NAID 10016913860