疟原虫 vivax 急性发作后与 HMS 相关的溶血性贫血。
HMS-related hemolysis after acute attacks of Plasmodium vivax malaria.
机构信息
Department of Medicine, Lihir Medical Centre - International SOS, Lihir Island, Papua New Guinea.
出版信息
Am J Trop Med Hyg. 2011 Oct;85(4):616-8. doi: 10.4269/ajtmh.2011.11-0145.
Abstract
Among a cohort of 1,213 cases treated for Plasmodium vivax malaria from an isolated Papua New Guinean population, seven adults with severe and sustained hemolytic anemia after clearance of the peripheral parasitemia were prospectively investigated. All the patients fulfilled the criteria for hyper-reactive malarial splenomegaly and in 2 of 7 cases an IgG warm antibody was identified. Hereditary hemolytic anemia was excluded in 5 of 5 patients. All treated cases improved after an initial high dose of prednisone and antimalarial chemoprophylaxis. The persistence of marked anemia in a patient with splenomegaly after a P. vivax attack should raise the suspicion of hyper-reactive malarial splenomegaly.
摘要
在一个由来自巴布亚新几内亚一个孤立人群中治疗的 1213 例间日疟原虫疟疾病例组成的队列中，前瞻性研究了 7 例在清除外周寄生虫血症后出现严重且持续溶血性贫血的成年人。所有患者均符合高反应性疟疾脾肿大的标准，其中 7 例中的 2 例发现 IgG 暖抗体。5 例患者排除遗传性溶血性贫血。所有治疗病例在用大剂量泼尼松和抗疟化学预防治疗后均有改善。在间日疟原虫感染后，脾肿大患者出现明显贫血持续存在，应怀疑为高反应性疟疾脾肿大。
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