Stühlinger W, Berek K, Grösswang F, Schauer N
Abteilung für Innere Medizin, Krankenhaus Kufstein, Osterreich.
Schweiz Med Wochenschr. 1990 Mar 10;120(10):345-8.
A report is presented on repeated severe episodes of cyanidanol-induced immune hemolysis in a 75-year-old woman suffering from chronic active hepatitis. One year after the first hemolytic episode, high titers of anticyanidanol antibodies were still demonstrated in the patient's serum (as well as sensitization of the patient's lymphocytes by the drug). 4 years later virtually no decrease of the antibody titer was found. Further investigations of the patient's serum revealed antibodies against flavonoids with free hydroxyl groups (cyanidanol and rutin). However, no antibodies against flavonoids with derivatized hydroxyl groups (troxerutin, mixture of hydroxy-ethyl-rutin and silibinin) could be demonstrated. Sensitization with flavonoids other than cyanidanol preceding cyanidanol-induced hemolysis has been proposed by others. In this case storage of approximately 75 flavonoid containing preparations in a chemist's shop in the patient's house may have contributed to the astonishing persistence of dry dependent antibodies.
本文报告了一名75岁患有慢性活动性肝炎的女性反复发生矢车菊素诱导的免疫性溶血严重发作的情况。首次溶血发作一年后，患者血清中仍显示出高滴度的抗矢车菊素抗体（以及药物对患者淋巴细胞的致敏作用）。4年后，抗体滴度几乎没有下降。对患者血清的进一步研究发现了针对具有游离羟基的黄酮类化合物（矢车菊素和芦丁）的抗体。然而，未检测到针对具有衍生化羟基的黄酮类化合物（曲克芦丁、羟乙基芦丁和水飞蓟宾混合物）的抗体。其他人曾提出在矢车菊素诱导的溶血之前用矢车菊素以外的黄酮类化合物致敏。在这种情况下，患者家中药店储存的约75种含黄酮类化合物的制剂可能导致了依赖干燥抗体惊人的持续性。
