Rizos Evangelos, Dimos George, Liberopoulos Evangelos N, Elisaf Moses S, Drosos Alexandros A
Department of Internal Medicine, Medical School, University of Ioannina, 451 10, Ioannina, Greece.
Rheumatol Int. 2005 Aug;25(6):469-71. doi: 10.1007/s00296-004-0533-2. Epub 2004 Nov 10.
Visceral leishmaniasis may present with cytopenias along with the formation of many autoantibodies and, rarely, with the presence of mixed cryoglobulinemia, type II, resembling an autoimmune disease. The syndrome of mixed cryoglobulinemia is characterized by the triad of purpura, arthralgias, and asthenia, in conjunction with cryoglobulins in the serum. In this article mixed cryoglobulinemia, type II, was diagnosed in a negative for hepatitis B or C patient suffering from visceral leishmaniasis. Antimicrobial therapy against leishmania eliminated the cryoglobulin titer, as well as the clinical manifestations of cryoglobulinemia. The role of the immune system and the type of immune response for the formation of cryoglobulins are discussed.
内脏利什曼病可能伴有血细胞减少以及多种自身抗体的形成，极少数情况下会出现Ⅱ型混合性冷球蛋白血症，类似于自身免疫性疾病。混合性冷球蛋白血症综合征的特征为紫癜、关节痛和乏力三联征，同时血清中存在冷球蛋白。本文报道了一名乙肝和丙肝均为阴性的内脏利什曼病患者被诊断为Ⅱ型混合性冷球蛋白血症。针对利什曼原虫的抗菌治疗消除了冷球蛋白滴度以及冷球蛋白血症的临床表现。文中还讨论了免疫系统的作用以及冷球蛋白形成的免疫反应类型。
