Suzuki Takashiro, Saito Shinichiro, Hirabayashi Yasuhiko, Harigae Hideo, Ishii Tomonori, Kodera Takao, Fujii Hiroshi, Munakata Yasuhiko, Sasaki Takeshi
Department of Internal Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574.
Intern Med. 2003 Jun;42(6):538-40. doi: 10.2169/internalmedicine.42.538.
A 42-year-old woman with systemic lupus erythematosus (SLE) had an episode of fever, arthralgia and anemia. In order to treat the suspected activation of SLE, the daily dose of steroid was increased, however, the anemia progressed and pancytopenia developed. Both IgM anti-B19 antibodies to human parvovirus B19 (B19) and B19 DNA were positive, and bone marrow analysis revealed pure red cell aplasia with giant proerythroblasts. High dose gamma globulin was administered and the daily dose of steroid was tapered, resulting in the improvement of her condition. B19 infection should be ruled out in cases with reactivation of autoimmune diseases.
一名42岁的系统性红斑狼疮(SLE)女性患者出现发热、关节痛和贫血症状。为治疗疑似SLE活动,增加了类固醇的每日剂量,然而,贫血仍进展并发展为全血细胞减少。针对人细小病毒B19(B19)的IgM抗B19抗体和B19 DNA均呈阳性,骨髓分析显示为伴有巨大早幼红细胞的纯红细胞再生障碍。给予大剂量丙种球蛋白并逐渐减少类固醇的每日剂量,患者病情得以改善。自身免疫性疾病复发的病例应排除B19感染。