Nakase T, Morita K, Tomeoku M, Katou M, Kanamaru M, Shirakawa S
Department of Internal Medicine, Kouseiren Tyuusei General Hospital.
Rinsho Ketsueki. 1990 Dec;31(12):1967-8.
A 66-year-old female was admitted to our hospital with lumbago. On admission, laboratory examination revealed hemolytic anemia. Direct Coombs' test was positive, and also direct monospecific-Coombs' test by anti-C3d serum was positive. Immunoelectrophoresis showed IgA-lambda type M proteins in serum. Bone marrow aspiration disclosed increased atypical plasma cells. X-ray of skull showed punched-out lesion. From these findings, she was diagnosed as IgA (lambda) myeloma complicating with autoimmune hemolytic anemia. Hemolysis was improved by chemotherapy. It was thought that IgA and C3 were related well to hemolysis in this case.
一名66岁女性因腰痛入院。入院时,实验室检查显示溶血性贫血。直接抗人球蛋白试验呈阳性,抗C3d血清直接单特异性抗人球蛋白试验也呈阳性。免疫电泳显示血清中有IgA-λ型M蛋白。骨髓穿刺显示非典型浆细胞增多。颅骨X线显示有凿孔样病变。根据这些发现,她被诊断为IgA(λ)骨髓瘤合并自身免疫性溶血性贫血。化疗后溶血情况得到改善。认为在该病例中IgA和C3与溶血密切相关。