寻找难以捉摸的致病性自身抗体：自身免疫性溶血性贫血的一个非典型病例。
Finding the elusive and causative autoantibody: An atypical case of autoimmune hemolytic anemia.
作者信息
Fetzko Stephanie, Ahmed Asra, Cooling Laura
机构信息
Internal Medicine and Pediatrics Residency Program, University of Michigan Health System 3116 Taubman Center, SPC 5368, 1500 E. Medical Center Drive, Ann Arbor, Michigan, 48198.
Department of Hematology and Oncology, University of Michigan Health System Ann Arbor, Michigan.
出版信息
Clin Case Rep. 2015 Apr;3(4):227-30. doi: 10.1002/ccr3.203. Epub 2015 Feb 2.
Abstract
An isolated IgA-mediated autoimmune hemolytic anemia can present a diagnostic challenge. When a routine direct antiglobulin test (DAT) is negative but clinical suspicion remains high, further testing with monospecific antisera should be performed. As with IgG-mediated WAIHA, steroids are first-line treatment, though splenectomy is often required to achieve a durable treatment response.
摘要
孤立性IgA介导的自身免疫性溶血性贫血可能带来诊断挑战。当常规直接抗球蛋白试验（DAT）为阴性但临床怀疑度仍很高时，应使用单特异性抗血清进行进一步检测。与IgG介导的温抗体型自身免疫性溶血性贫血（WAIHA）一样，类固醇是一线治疗方法，不过通常需要行脾切除术以获得持久的治疗反应。
相似文献
1
Finding the elusive and causative autoantibody: An atypical case of autoimmune hemolytic anemia.寻找难以捉摸的致病性自身抗体：自身免疫性溶血性贫血的一个非典型病例。
Clin Case Rep. 2015 Apr;3(4):227-30. doi: 10.1002/ccr3.203. Epub 2015 Feb 2.
2
A Case of Coombs-Negative Primary Warm Autoimmune Hemolytic Anemia Due to IgA Antibody That Responded Well to Rituximab and Steroids.一例由IgA抗体引起的抗人球蛋白试验阴性的原发性温抗体型自身免疫性溶血性贫血，对利妥昔单抗和类固醇治疗反应良好。
Cureus. 2024 Jul 1;16(7):e63598. doi: 10.7759/cureus.63598. eCollection 2024 Jul.
3
Warm Autoimmune Hemolytic Anemia and Direct Antiglobulin Testing With a False-Negative Result in a 53-Year-Old Man: The DAT Will Set You Free.一名53岁男性的温抗体型自身免疫性溶血性贫血与直接抗人球蛋白试验假阴性结果：直接抗人球蛋白试验会让你找到答案。
Lab Med. 2016 Aug;47(3):227-32. doi: 10.1093/labmed/lmw018. Epub 2016 Jun 10.
4
Autoimmune hemolytic anemia associated with IgA--diagnostic and therapeutic aspects in a case with long-term follow-up.与IgA相关的自身免疫性溶血性贫血——1例长期随访病例的诊断与治疗方面
Acta Haematol. 1987;77(1):53-6. doi: 10.1159/000205951.
5
Warm autoimmune hemolytic anemia: experience from a single referral center in Mexico City.温抗体型自身免疫性溶血性贫血：来自墨西哥城一家转诊中心的经验。
Blood Res. 2017 Mar;52(1):44-49. doi: 10.5045/br.2017.52.1.44. Epub 2017 Mar 27.
6
Severe IgA-mediated auto-immune haemolytic anaemia in a 48-yr-old woman.一名48岁女性的严重IgA介导的自身免疫性溶血性贫血。
Eur J Haematol. 2003 Jan;70(1):60-3. doi: 10.1034/j.1600-0609.2003.02846.x.
7
Clinical perspectives, immunohematologic insights, and transfusion management in IgA-associated autoimmune hemolytic anemia.IgA 相关性自身免疫性溶血性贫血的临床观点、免疫血液学见解和输血管理。
Immunohematology. 2022 Sep 22;38(3):82-89. doi: 10.21307/immunohematology-2022-047. Print 2022 Sep 1.
8
A Comprehensive Diagnostic Algorithm for Direct Antiglobulin Test-Negative Autoimmune Hemolytic Anemia Reveals the Relative Ratio of Three Mechanisms in a Single Laboratory.一种用于直接抗球蛋白试验阴性自身免疫性溶血性贫血的综合诊断算法揭示了单一实验室中三种机制的相对比例。
Acta Haematol. 2018;140(1):10-17. doi: 10.1159/000488753. Epub 2018 Jul 13.
9
Diagnostic algorithm for classification and characterization of direct antiglobulin test-negative autoimmune hemolytic anemia with 1-year clinical follow-up.伴有 1 年临床随访的直接抗球蛋白试验阴性自身免疫性溶血性贫血分类和特征诊断算法。
Transfusion. 2022 Jan;62(1):205-216. doi: 10.1111/trf.16709. Epub 2021 Oct 19.
10
Influence of immunohematological markers on severity of in vivo hemolysis in human warm autoimmune haemolytic anemia.免疫血液学标志物对人类温抗体自身免疫性溶血性贫血体内溶血严重程度的影响。
Transfus Apher Sci. 2022 Dec;61(6):103492. doi: 10.1016/j.transci.2022.103492. Epub 2022 Jun 26.
引用本文的文献
1
Vesiculation as potential novel pathogenic mechanism in autoimmune hemolytic anemia.水泡形成作为自身免疫性溶血性贫血潜在的新致病机制。
Transfusion. 2025 Jun;65(6):1132-1144. doi: 10.1111/trf.18270. Epub 2025 May 12.
本文引用的文献
1
IgA-mediated autoimmune haemolytic anaemia in a 9-year renal transplanted patient.一名9岁肾移植患者的IgA介导的自身免疫性溶血性贫血
NDT Plus. 2008 Feb;1(1):28-29. doi: 10.1093/ndtplus/sfm015. Epub 2007 Dec 19.
2
Characterization of direct antiglobulin test-negative autoimmune hemolytic anemia: a study of 154 cases.直接抗球蛋白试验阴性自身免疫性溶血性贫血的特征：154 例研究。
Am J Hematol. 2013 Feb;88(2):93-6. doi: 10.1002/ajh.23356. Epub 2012 Nov 21.
3
IgA-mediated autoimmune hemolytic anemia in an infant.婴儿的 IgA 介导的自身免疫性溶血性贫血。
Pediatr Blood Cancer. 2011 May;56(5):837-9. doi: 10.1002/pbc.22932. Epub 2010 Dec 22.
4
How I treat autoimmune hemolytic anemias in adults.成人自身免疫性溶血性贫血的治疗方法。
Blood. 2010 Sep 16;116(11):1831-8. doi: 10.1182/blood-2010-03-259325. Epub 2010 Jun 14.
5
Drug-induced immune hemolytic anemia.药物诱导免疫性溶血性贫血。
Hematology Am Soc Hematol Educ Program. 2009:73-9. doi: 10.1182/asheducation-2009.1.73.
6
Rituximab for warm-type idiopathic autoimmune hemolytic anemia: a retrospective study of 11 adult patients.利妥昔单抗治疗温抗体型自身免疫性溶血性贫血：11例成年患者的回顾性研究
Eur J Haematol. 2007 Jul;79(1):53-8. doi: 10.1111/j.1600-0609.2007.00861.x. Epub 2007 May 28.
7
Severe IgA-mediated autoimmune haemolytic anaemia in Hodgkin lymphoma: a very rare event.霍奇金淋巴瘤中严重的免疫球蛋白A介导的自身免疫性溶血性贫血：一种极为罕见的情况。
Leuk Lymphoma. 2007 Mar;48(3):633-5. doi: 10.1080/10428190601120357.
8
Autoimmune hemolytic anemia due to IgA class autoantibodies.IgA类自身抗体所致的自身免疫性溶血性贫血
Immunohematology. 1996;12(1):14-9.
9
Autoimmune hemolytic anemia.自身免疫性溶血性贫血
Am J Hematol. 2002 Apr;69(4):258-71. doi: 10.1002/ajh.10062.
10
Intravascular hemolysis by IgA red cell autoantibodies.IgA红细胞自身抗体介导的血管内溶血。
Neth J Med. 2001 May;58(5):204-7. doi: 10.1016/s0300-2977(01)00096-1.
Zotero 插件