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[溶血性贫血]

[Hemolytic anemia].

作者信息

Tuchscherer A, Chemnitz J

机构信息

Klinik I für Innere Medizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland,

出版信息

Internist (Berl). 2015 Sep;56(9):1000-8. doi: 10.1007/s00108-015-3661-8.

Abstract

Hemolytic anemia can be caused by various hereditary or acquired diseases. Classification is usually based on corpuscular or extracorpuscular defects. Beside the anemia, laboratory testing indicates increased lactate dehydrogenase, unconjugated bilirubin and reticulocytes as well as reduced or absent plasma haptoglobin. Knowledge of further diagnostic procedures (e.g., Coombs test, schistocytes, hemoglobin electrophoresis or flow cytometric analysis) leads in many cases to an underlying disease with differentiated therapeutic options. Autoimmune hemolytic anemia (AIHA) is often associated with diseases as HIV, connective tissue disease, lymphomas or malignant tumors and the hemolytic process is preexisting in many cases. Thrombotic microvascular diseases (e.g., thrombotic thrombocytopenic purpura or hemolytic-uremic syndrome) are further important causes of hemolytic anemia which need immediate diagnosis and treatment.

摘要

溶血性贫血可由多种遗传性或后天性疾病引起。分类通常基于红细胞或红细胞外缺陷。除贫血外,实验室检查显示乳酸脱氢酶、非结合胆红素和网织红细胞增加,以及血浆结合珠蛋白减少或缺乏。了解进一步的诊断程序(如抗人球蛋白试验、裂体细胞、血红蛋白电泳或流式细胞术分析)在许多情况下可明确潜在疾病并提供不同的治疗选择。自身免疫性溶血性贫血(AIHA)常与HIV、结缔组织病、淋巴瘤或恶性肿瘤等疾病相关,且溶血过程在许多情况下早已存在。血栓性微血管病(如血栓性血小板减少性紫癜或溶血尿毒综合征)是溶血性贫血的其他重要病因,需要立即诊断和治疗。

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