title: [Esophagogastric variceal bleeding in a case of liver cirrhosis associated with thalassemia].
abstract: A 58-year-old man was admitted to our hospital because of hematemesis. Laboratory tests indicated microcytic hypochromic anemia and iron overload. We performed urgent endoscopic examination, and diagnosed bleeding from esophagogastric varices. Abdominal CT showed liver cirrhosis and marked splenomegaly, but no evidence of gastrorenal shunt. The varices were treated by Hassab's operation and splenectomy. Pathologic examination revealed hepatocytes in the cirrhotic nodules filled with iron pigment. The cause of the liver cirrhosis was considered to be due to iron overload resulting from thalassemia. We diagnosed the cause of the microcytic anemia as thalassemia by gene analysis, which revealed heterozygosity of a deletion (deltabeta thalassemia Jpn-type II) and one point mutation (-31A-->G).
authors.affiliation: Department of Gastroenterology, Hitachi General Hospital. akihisa.ishikawa.cr@hitachi.com
authors.forename: Akihisa
authors.initials: A
authors.lastname: Ishikawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohkawara
authors.forename: Nobushige
authors.initials: N
authors.lastname: Kakinoki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kamoshida
authors.forename: Shinji
authors.initials: S
authors.lastname: Hirai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Oka
mesh_terms: D004932:Esophageal and Gastric Varices / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013789:Thalassemia / Q000150:complications*