Inoue F, Miyake N, Yamasowa M, Ohno T, Takamatsu T, Okada T, Mizumoto T, Furukawa H, Saka Y, Aoki Y
Department of Internal Medicine, Otsu Red Cross Hospital.
Rinsho Ketsueki. 1992 Jun;33(6):801-5.
A case of Mycoplasma pneumonia complicated with severe hemolytic anemia, which occurred as a result of a high titer of cold agglutinin is presented. A 49 year-old male was admitted because of fever, jaundice and dyspnea. Chest x-ray showed diffuse small nodular infiltrates throughout both lung fields. Laboratory studies disclosed the following values: Hb 4.6 g/dl, Ht 13.9%, reticulocyte 11.5%, direct and indirect Coombs' test positive, haptoglobin 38 mg/dl, ESR 145 mm/hr, cold agglutinin titer 1:2,048 mycoplasma antibody titer 1:640, PPD negative. The diagnosis of autoimmune hemolytic anemia associated with Mycoplasma pneumonia was made, and treatment with minocycline and prednisolone observed striking clinical improvement. It was suggested that the cold exposure was possibly a major factor in the pathogenesis of hemolysis in this patient.
本文报告1例因高滴度冷凝集素导致的支原体肺炎并发严重溶血性贫血病例。一名49岁男性因发热、黄疸和呼吸困难入院。胸部X线显示双肺野弥漫性小结节浸润。实验室检查结果如下：血红蛋白4.6g/dl，血细胞比容13.9%，网织红细胞11.5%，直接和间接抗人球蛋白试验阳性，触珠蛋白38mg/dl，红细胞沉降率145mm/hr，冷凝集素滴度1:2048，支原体抗体滴度1:640，结核菌素试验阴性。诊断为支原体肺炎相关的自身免疫性溶血性贫血，米诺环素和泼尼松龙治疗后临床症状显著改善。提示寒冷暴露可能是该患者溶血发病机制中的主要因素。
