Nishino Ryuhei, Ikeda Naoki, Unoura Masashi
Department of Internal Medicine, Hakui Public Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2011 Sep;108(9):1571-8.
A 49-year-old man with chronic type C hepatitis had agreed to undergo pegylated interferon alpha2b/ribavirin (RBV) combination therapy during 48 weeks, but his hepatitis relapsed. Despite of second line treatment with the same combination, 56 weeks later, his hemoglobin decreased and the dose of RBV was decreased. He was then admitted to our hospital because of increasing anemia and this combination therapy was stopped. The results of blood chemistry and immunological examination revealed he had contracted autoimmune hemolytic anemia (AIHA). In cases of deterioration of anemia during this combination, we must discuss about not only RBV-induced hemolytic anemia but also AIHA.
一名49岁的慢性丙型肝炎男性患者同意接受聚乙二醇化干扰素α2b/利巴韦林(RBV)联合治疗48周,但肝炎复发。尽管采用相同联合方案进行二线治疗,56周后,他的血红蛋白下降,RBV剂量降低。随后,他因贫血加重入住我院,该联合治疗被停用。血液化学和免疫学检查结果显示他患有自身免疫性溶血性贫血(AIHA)。在这种联合治疗期间出现贫血恶化的病例中,我们不仅要讨论RBV诱导的溶血性贫血,还要讨论AIHA。