Selleslag D L, Geraghty R J, Ganesan T S, Slevin M L, Wrigley P F, Brown R
Acta Clin Belg. 1989;44(3):199-201. doi: 10.1080/17843286.1989.11718015.
A 57-year-old man with a history of pulmonary asbestosis was incidentally found to have benign mesothelial hyperplasia of the peritoneum at hernia repair. Five months later he developed a Coombs positive haemolytic anaemia of the IgG-C3d type caused by non specific IgG antibodies. At that time no underlying cause for the anaemia was found. The anaemia responded to steroids, but remained steroid dependent. Six months after the diagnosis of the anaemia, a malignant peritoneal mesothelioma was found at laparotomy. The association between malignant mesothelioma and autoimmune haemolytic anaemia has been reported on one previous occasion. The description of a second case suggests that the association is not purely coincidental and that malignant mesothelioma should be added to the list of solid tumours that can be associated with autoimmune haemolytic anaemia. The finding of red blood cells coated with IgG and C3d in this as well as in other cases adds further evidence to the hypothesis that a quinidine type mechanism of haemolysis might be responsible for Coombs positive haemolytic anaemia associated with solid tumours.
一名有肺石棉沉着病史的57岁男性在疝修补术中偶然发现腹膜良性间皮增生。五个月后，他出现了由非特异性IgG抗体引起的IgG - C3d型库姆斯阳性溶血性贫血。当时未发现贫血的潜在病因。贫血对类固醇有反应，但仍依赖类固醇。贫血诊断六个月后，剖腹手术发现恶性腹膜间皮瘤。此前曾有一次报道过恶性间皮瘤与自身免疫性溶血性贫血之间的关联。第二例病例的描述表明这种关联并非纯粹巧合，恶性间皮瘤应被添加到可能与自身免疫性溶血性贫血相关的实体瘤列表中。在该病例以及其他病例中发现红细胞被IgG和C3d包被，进一步证明了溶血的奎尼丁型机制可能是与实体瘤相关的库姆斯阳性溶血性贫血的病因这一假说。
