Han Xiang, He Bei, Wang Fei
Respiratory Department of Peking University Third Hospital, Beijing 100191, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2011 Nov;34(11):832-6.
To improve the understanding of hemolytic anemia secondary to Mycoplasma pneumonia.
One case of hemolytic anemia secondary to Mycoplasma pneumonia in an adult was reported. With "Mycoplasma pneumonia, hemolytic anemia, adult, case report" as the search terms, and the search time ranged from 1967.1 to 2011.3 for PubMed and 1978.1 to 2011.3 for Wanfangdata, 9 cases of similar clinical cases in the literatures were reviewed.
A 29 year-old female patient was admitted to the hospital because of fever with cough and sputum production for 15 days. The chest X-ray showed pneumonia on the left lower lung. On day 14, the patient's hemoglobin decreased, to a minimum of 83 g/L, and the reticulocyte was 0.04, and the blood agglutinated in the tube. The IgM antibody for mycoplasma was positive, and the cold agglutinin titer was 1:256. After antibiotic therapy, the level of hemoglobin increased and the lesions of the lung recovered. The diagnosis was mycoplasma pneumonia associated with hemolytic anemia. Nine adult cases of mycoplasma pneumonia associated with hemolytic anemia were collected by review of the literature. Of the 10 cases, 6 was male and 4 was female, age was from 29 to 60. In 8 of the 10 cases, hemolytic anemia occurred in 8 - 18 days, and the cold agglutinin titer increased in all cases, 1:1024 or more in 7 cases. Endovascular thrombosis occurred in 2 cases. Nine patients recovered and 1 died.
Hemolytic anemia secondary to Mycoplasma pneumonia often occurs during 2 - 3 weeks of illness. Hemolysis is related to the high titer of cold agglutinin. Endovascular thrombosis can occur in some cases, and the majority of patients have a good prognosis, but death can occur in very severe cases.
提高对支原体肺炎继发溶血性贫血的认识。
报告1例成人支原体肺炎继发溶血性贫血病例。以“支原体肺炎、溶血性贫血、成人、病例报告”为检索词，检索时间范围为1967年1月至2011年3月的PubMed数据库以及1978年1月至2011年3月的万方数据库，回顾文献中9例类似临床病例。
一名29岁女性患者因发热伴咳嗽咳痰15天入院。胸部X线显示左下肺肺炎。第14天，患者血红蛋白下降，最低至83g/L，网织红细胞为0.04，试管内血液发生凝集。支原体IgM抗体阳性，冷凝集素效价为1:256。抗生素治疗后，血红蛋白水平升高，肺部病变恢复。诊断为支原体肺炎合并溶血性贫血。通过文献回顾收集到9例成人支原体肺炎合并溶血性贫血病例。10例中，男性6例，女性4例，年龄29至60岁。10例中的8例在发病8至18天出现溶血性贫血，所有病例冷凝集素效价均升高，7例≥1:1024。2例发生血管内血栓形成。9例患者康复，1例死亡。
支原体肺炎继发溶血性贫血常发生在病程2至3周。溶血与冷凝集素高滴度有关。部分病例可发生血管内血栓形成，多数患者预后良好，但极严重病例可导致死亡。
