Kim Na Yeon, Kim Joon Hwan, Park Jin Suk, Kim Soo Hyun, Cho Yeon Kyung, Cha Dong Hyun, Kim Ki Eun, Kang Myung Suh, Lim Kyung Ah, Sheen Youn Ho
Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
Korean J Pediatr. 2016 Nov;59(Suppl 1):S60-S63. doi: 10.3345/kjp.2016.59.11.S60. Epub 2016 Nov 30.
Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.
在此，我们报告了一例罕见的溶血性贫血合并网织红细胞减少症的病例，该病例发生在一名接受静脉注射免疫球蛋白治疗的川崎病幼儿身上。一名2个月大的男孩出现持续3天的发热、结膜充血、草莓舌、手部红斑性水肿和斑丘疹，这些症状和体征提示为不完全川崎病。在使用阿司匹林和大剂量静脉注射免疫球蛋白治疗8天后，他的发热症状消退。血红蛋白和血细胞比容分别从9.7 g/dL和27.1%降至7.4 g/dL和21.3%。该患者为正细胞低色素性贫血，伴有红细胞大小不均、异形红细胞、未成熟中性粒细胞和有核红细胞。直接抗球蛋白试验结果为阳性，网织红细胞计数为1.39%。患者康复过程顺利。然而，出院1个月后网织红细胞减少症仍持续存在。
