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To the Editor:—
The 43-year-old man with thrombocytopenia, foam cells typical of "familial splenic anemia," and negative skeletal roentgenograms (Questions and Answers, JAMA174:1759, 1960) undoubtedly has Gaucher's disease. This diagnosis can easily be established by the characteristic appearance of the bone marrow cells. Symptomatic thrombocytopenia in this disease often responds to splenectomy. Patients with Gaucher's disease often live comfortably and without symptoms. Since the man's spleen is removed, it is unlikely that he will develop progressive anemia. If he is hematologically normal and symptom-free at this time, his insurance risk is quite good and can be considered impaired mildly, if at all.
Motulsky AG. Splenic Anemia. JAMA. 1961;175(12):1110-1111. doi:10.1001/jama.1961.03040120072025