Rabinowitz A P, Sacks Y, Carmel R
Department of Medicine, Los Angeles County-USC Medical Center.
Eur J Haematol. 1990 Jan;44(1):18-23. doi: 10.1111/j.1600-0609.1990.tb00341.x.
Pernicious anemia appears to be autoimmune in origin and is associated with immune disorders of several organ systems. We report 4 patients with pernicious anemia and immune cytopenias, an association that may sometimes pose diagnostic problems unless specifically considered. Pernicious anemia coexisted with or was closely followed by idiopathic thrombocytopenic purpura in 3 patients and by autoimmune hemolytic anemia in a 4th patient. In addition to cobalamin therapy, all patients required corticosteroids (2 also received danazol), while 1 also required splenectomy. All 4 patients were women. The 3 patients with idiopathic thrombocytopenic purpura were also blood group O and were iron-deficient. Autoimmune cytopenias may occur in patients with treated or untreated pernicious anemia and require specific therapy.
恶性贫血似乎起源于自身免疫，且与多个器官系统的免疫紊乱有关。我们报告了4例患有恶性贫血和免疫性血细胞减少症的患者，这种关联有时可能会带来诊断问题，除非特别考虑。3例患者中，恶性贫血与特发性血小板减少性紫癜共存或紧随其后出现，第4例患者则伴有自身免疫性溶血性贫血。除了钴胺素治疗外，所有患者均需要使用皮质类固醇（2例还接受了达那唑治疗），而1例患者还需要进行脾切除术。所有4例患者均为女性。3例特发性血小板减少性紫癜患者血型均为O型，且缺铁。自身免疫性血细胞减少症可能发生在接受或未接受治疗的恶性贫血患者中，需要进行特异性治疗。
