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症例は58歳, 糖尿病による慢性腎不全の女性. 2003年12月, 左被殻出血の脳室穿破にて入院. 開頭術後に維持血液透析となった. 第8病日より経管栄養を行っていたが, 第100病日頃より徐々に貧血が進行. 貧血はエリスロポエチン製剤に反応せず, 顆粒球減少症も伴ったため, 赤血球輸血および顆粒球コロニー刺激因子製剤投与を頻回に必要とした. 鉄, ビタミンB12, 葉酸の欠乏はなく, 自己抗体, 腫瘍マーカー, 血清免疫電気泳動, 胸腹部CT検査にても異常所見は得られなかった. 薬剤の影響も考え, 脳出血後に開始したすべての薬剤を中止したが, 中止1か月後でも貧血・顆粒球減少症は改善しなかった. 第160病日, 骨髄穿刺にて顆粒球系の空泡化変性を認め, 同日の血液検査にて, 銅およびセルロプラスミンの異常低値が判明した. 銅欠乏による貧血・顆粒球減少症と診断. 経静脈的な硫酸銅製剤投与 (1.25mg/日) にて, 速やかに貧血改善と顆粒球増加を認めた. 食事摂取が可能になった後は, 銅投与を中止しても貧血・顆粒球減少症は生じなかった. 経静脈栄養や経管栄養を施行している血液透析患者における貧血や顆粒球減少症の鑑別診断として, 銅欠乏を考慮に入れる必要がある.

With the aim of elucidating in greater detail the genealogical origin of the present domestic fowls of the world, we have determined mtDNA sequences of the D-loop regions for a total of 21 birds, of which 12 samples belong to red junglefowl (Gallus gallus) comprising three subspecies (six Gallus gallus gallus, three Gallus gallus spadiceus, and three Gallus gallus bankiva) and nine represent diverse domestic breeds (Gallus gallus domesticus). We also sequenced four green junglefowl (Gallus varius), two Lafayette's junglefowl (Gallus lafayettei), and one grey junglefowl (Gallus sonneratii). We then constructed a phylogenetic tree for these birds by the use of nucleotide sequences, choosing the Japanese quail (Coturnix coturnix japonica) as an outgroup. We found that a continental population of G. g. gallus was the real matriarchic origin of all the domestic poultries examined in this study. It is also of particular interest that there were no discernible differences among G. gallus subspecies; G. g. bankiva was a notable exception. This was because G. g. spadiceus and a continental population of G. g. gallus formed a single cluster in the phylogenetic tree. G. g. bankiva, on the other hand, was a distinct entity, thus deserving its subspecies status. It implies that a continental population of G. g. gallus sufficed as the monophyletic ancestor of all domestic breeds. We also discussed a possible significance of the initial dispersal pattern of the present domestic fowls, using the phylogenetic tree.