Murray J C, Bernini J C, Bijou H L, Rossmann S N, Mahoney D H, Morad A B
Hematology and Oncology Center, Cook Children's Medical Center, Fort Worth, Texas 76104, USA.
J Pediatr Hematol Oncol. 2001 Jun-Jul;23(5):318-20. doi: 10.1097/00043426-200106000-00018.
Autoimmune hemolytic anemia (AIHA) is a hematologic disorder that is rarely seen in infants and young children. Most cases are associated with viral or bacterial infection, but the immunologic events leading to hemolysis are poorly understood. We describe two infants with severe cytomegalovirus (CMV)-associated warm antibody AIHA. One case was immunohematologically analyzed and showed suggestive evidence that endogenous anti-CMV IgG antibodies were the pathogenic antibodies leading to hemolysis, implicating a possible causal relationship between AIHA and CMV infection. Both patients were ultimately treated with intravenous CMV immune globulin, with subsequent improvement. These cases suggest that investigation for the presence of CMV in infantile AIHA is warranted and that CMV immune globulin should be considered as a therapeutic option.
自身免疫性溶血性贫血（AIHA）是一种血液系统疾病，在婴幼儿中罕见。大多数病例与病毒或细菌感染有关，但导致溶血的免疫过程尚不清楚。我们描述了两名患有严重巨细胞病毒（CMV）相关温抗体型AIHA的婴儿。对其中一例进行了免疫血液学分析，结果显示有提示性证据表明内源性抗CMV IgG抗体是导致溶血的致病抗体，这意味着AIHA与CMV感染之间可能存在因果关系。两名患者最终均接受了静脉注射CMV免疫球蛋白治疗，随后病情有所改善。这些病例表明，对婴儿AIHA患者进行CMV检测是有必要的，并且CMV免疫球蛋白应被视为一种治疗选择。
