Sameiro Barreirinho M, Lopes Guerra M, Sousa Costa E, Manuel Couceiro A, Rodrigues Neves E, Morais Barbot J
Servicio de Hematología.Hospital de CrianCas Maria Pia. Porto. Portugal.
An Esp Pediatr. 2002 May;56(5):459-61.
The authors report the case of a previously healthy 5-year-old boy who, 1 month after tonsillitis, presented severe aregenerative anemia, macrocytosis, and increased hemoglobin F associated with mild thrombocytopenia. Peripheral blood smear showed no significant alterations and bone marrow aspirate revealed markedly decreased red blood cell precursors. Etiological investigation showed elevated titers of Epstein-Barr virus antibodies (IgM anti-viral capsid antigen). Bone marrow biopsy showed no criteria for red cell aplasia and in situ hybridization revealed intracellular Epstein-Barr virus. Reticulocytosis emerged from days 10-17 of follow-up, together with rising hemoglobin. Mean corpuscular volume and hemoglobin F returned to normal 2 months later. Immunological study revealed partial IgG3 deficit that persisted after 1 year of follow-up.
作者报告了一例既往健康的5岁男孩的病例，该男孩在扁桃体炎1个月后出现严重的再生障碍性贫血、大细胞性贫血，血红蛋白F升高并伴有轻度血小板减少。外周血涂片未见明显异常，骨髓穿刺显示红细胞前体细胞明显减少。病因学调查显示，EB病毒抗体（IgM抗病毒衣壳抗原）滴度升高。骨髓活检未显示红细胞再生障碍的标准，原位杂交显示细胞内有EB病毒。随访第10 - 17天出现网织红细胞增多，同时血红蛋白升高。2个月后平均红细胞体积和血红蛋白F恢复正常。免疫学研究显示部分IgG3缺乏，随访1年后仍持续存在。
