Iida Tomoya, Satoh Shuji, Nakagaki Suguru, Shimizu Haruo, Kaneto Hiroyuki
Department of Gastroenterology, Muroran City General Hospital, Japan.
Intern Med. 2016;55(6):677-81. doi: 10.2169/internalmedicine.55.5657. Epub 2016 Mar 15.
A 50-year-old man was admitted to our hospital for an adhesive ileus 14 years after total abdominal colectomy for ulcerative colitis (UC). The ileus decreased with conservative treatment, however, autoimmune hemolytic anemia (AIHA) was diagnosed due to worsening anemia, a positive direct Coombs test, low haptoglobin, high lactase dehydrogenase, reticulocytosis, and an increase in the erythroblastic series in a bone-marrow examination. Human parvovirus B19 (PV-B19) IgM and PV-B19 DNA were present, indicating the development of AIHA triggered by an infection with PV-B19. The patient is currently being monitored after spontaneous remission. This is the first report of UC after total abdominal colectomy complicated by AIHA triggered by PV-B19 infection.
一名50岁男性因溃疡性结肠炎(UC)行全腹结肠切除术后14年,因粘连性肠梗阻入院。经保守治疗肠梗阻有所缓解,然而,由于贫血加重、直接抗人球蛋白试验阳性、触珠蛋白降低、乳酸脱氢酶升高、网织红细胞增多以及骨髓检查中幼红细胞系列增加,诊断为自身免疫性溶血性贫血(AIHA)。检测发现人细小病毒B19(PV-B19)IgM和PV-B19 DNA阳性,表明AIHA是由PV-B19感染引发。患者目前在自发缓解后接受监测。这是首例全腹结肠切除术后UC并发由PV-B19感染引发的AIHA的报告。