Grace Rachael F, Zanella Alberto, Neufeld Ellis J, Morton D Holmes, Eber Stefan, Yaish Hassan, Glader Bertil
Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, Massachusetts.
Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Am J Hematol. 2015 Sep;90(9):825-30. doi: 10.1002/ajh.24088. Epub 2015 Aug 14.
Over the last several decades, our understanding of the genetic variation, pathophysiology, and complications of the hemolytic anemia associated with red cell pyruvate kinase deficiency (PKD) has expanded. Nonetheless, there remain significant gaps in our knowledge with regard to clinical care and monitoring. Treatment remains supportive with phototherapy and/or exchange transfusion in the newborn period, regular or intermittent red cell transfusions in children and adults, and splenectomy to decrease transfusion requirements and/or anemia related symptoms. In this article, we review the clinical diversity of PKD, the current standard of treatment and for supportive care, the complications observed, and future treatment directions.
在过去几十年里,我们对与红细胞丙酮酸激酶缺乏症(PKD)相关的溶血性贫血的基因变异、病理生理学及并发症的认识有所扩展。尽管如此,在临床护理和监测方面,我们的认知仍存在重大差距。治疗仍以支持性治疗为主,新生儿期采用光疗和/或换血疗法,儿童和成人采用定期或间歇性红细胞输血,以及进行脾切除术以减少输血需求和/或与贫血相关的症状。在本文中,我们回顾了PKD的临床多样性、当前的治疗标准和支持性护理、观察到的并发症以及未来的治疗方向。