Wang P L, Liou L B, Dunn P
Division of Rheumatology, Allergy and Clinical Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, R.O.C.
Chang Gung Med J. 2001 Feb;24(2):125-9.
Very few cases of rheumatoid arthritis combined with pernicious anemia have been reported in the world literature and none in the Chinese literature. A 62-year-old female initially presented with anemia. Pernicious anemia was diagnosed by characteristic blood and bone marrow morphology. Laboratory data showed a deficiency of vitamin B12 and positive anti-gastric parietal cell antibodies. Her anemia improved after vitamin B12 therapy. Painful swelling of multiple joints developed 6 years later. The clinical presentation supported a diagnosis of rheumatoid arthritis. We report herein a rare case of rheumatoid arthritis and pernicious anemia in the same ethnic Chinese patient. We also review the literature and discuss a possible association between a non-organ-specific autoimmune disease, rheumatoid arthritis, and an organ-specific autoimmune disease, pernicious anemia.
世界文献中报道的类风湿关节炎合并恶性贫血的病例极少，中文文献中尚无相关报道。一名62岁女性最初表现为贫血。通过特征性的血液和骨髓形态学诊断为恶性贫血。实验室数据显示维生素B12缺乏且抗胃壁细胞抗体阳性。维生素B12治疗后其贫血症状有所改善。6年后出现多个关节疼痛肿胀。临床表现支持类风湿关节炎的诊断。我们在此报告一例罕见的同种族中国患者同时患有类风湿关节炎和恶性贫血的病例。我们还回顾了文献并讨论了一种非器官特异性自身免疫性疾病——类风湿关节炎与一种器官特异性自身免疫性疾病——恶性贫血之间可能存在的关联。
