与巴贝斯虫病相关的自身免疫性溶血性贫血。
Autoimmune hemolytic anemia associated with babesiosis.
作者信息
Narurkar Roshni, Mamorska-Dyga Aleksandra, Nelson John C, Liu Delong
机构信息
Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595 USA.
出版信息
Biomark Res. 2017 Apr 8;5:14. doi: 10.1186/s40364-017-0095-6. eCollection 2017.
Abstract
BACKGROUND
Babesiosis is endemic in selected areas in North America. Babesia infection is commonly associated with anemia, thrombocytopenia, hyponatremia and elevated liver enzymes. Autoimmune hemolytic anemia (AIHA) is known to be caused by parasitic and viral infections but has not been well characterized.
CASE PRESENTATION
We describe two cases diagnosed with babesiosis triggering severe AIHA. One case had history of splenectomy, and the other was an elderly patient. Older, immunocompromised and asplenic patients may be particularly at risk for post-babesiosis AIHA (PB-AIHA).
CONCLUSIONS
The pathogenesis for conventional AIHA and PB-AIHA appears to be different, since splenectomy is a treatment for conventional AIHA, whereas PB-AIHA is seen more often in asplenic patients. Further investigation into this intriguing mechanism of host immune response to babesiosis may help to elucidate the overall mechanism of infection- triggered AIHA.
摘要
背景
巴贝斯虫病在北美部分地区呈地方性流行。巴贝斯虫感染通常与贫血、血小板减少、低钠血症及肝酶升高有关。自身免疫性溶血性贫血（AIHA）已知可由寄生虫和病毒感染引起，但尚未得到充分表征。
病例报告
我们描述了两例诊断为巴贝斯虫病引发严重AIHA的病例。一例有脾切除史，另一例为老年患者。年龄较大、免疫功能低下及无脾患者可能特别容易发生巴贝斯虫病后AIHA（PB-AIHA）。
结论
传统AIHA和PB-AIHA的发病机制似乎不同，因为脾切除术是传统AIHA的一种治疗方法，而PB-AIHA在无脾患者中更常见。对宿主针对巴贝斯虫病的免疫反应这一有趣机制的进一步研究可能有助于阐明感染引发AIHA的总体机制。
相似文献
1
Autoimmune hemolytic anemia associated with babesiosis.与巴贝斯虫病相关的自身免疫性溶血性贫血。
Biomark Res. 2017 Apr 8;5:14. doi: 10.1186/s40364-017-0095-6. eCollection 2017.
2
Profound autoimmune hemolysis and Evans syndrome in two asplenic patients with babesiosis.两名患有巴贝斯虫病的无脾患者发生严重自身免疫性溶血和伊文氏综合征。
Transfusion. 2015 Mar;55(3):661-5. doi: 10.1111/trf.12901. Epub 2014 Oct 29.
3
Autoimmune Hemolytic Anemia Associated With Human Babesiosis.与人类巴贝斯虫病相关的自身免疫性溶血性贫血
J Hematol. 2021 Apr;10(2):41-45. doi: 10.14740/jh820. Epub 2021 Apr 27.
4
Post-Babesiosis Warm Autoimmune Hemolytic Anemia.巴贝虫病后自身免疫性溶血性贫血。
N Engl J Med. 2017 Mar 9;376(10):939-946. doi: 10.1056/NEJMoa1612165.
5
Efficacy and safety of rituximab in auto-immune hemolytic anemia: A meta-analysis of 21 studies.利妥昔单抗治疗自身免疫性溶血性贫血的疗效和安全性：21 项研究的荟萃分析。
Autoimmun Rev. 2015 Apr;14(4):304-13. doi: 10.1016/j.autrev.2014.11.014. Epub 2014 Dec 9.
6
Predictors of autoimmune hemolytic anemia in beta-thalassemia patients with underlying red blood cells autoantibodies.伴有基础红细胞自身抗体的β-地中海贫血患者自身免疫性溶血性贫血的预测因素。
Blood Cells Mol Dis. 2019 Nov;79:102342. doi: 10.1016/j.bcmd.2019.102342. Epub 2019 Jun 29.
7
Mixed Warm and Cold Autoimmune Hemolytic Anemia With Concomitant Immune Thrombocytopenia Following Recent SARS-CoV-2 Infection and Ongoing Rhinovirus Infection.近期感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）并持续感染鼻病毒后出现的冷热混合性自身免疫性溶血性贫血伴免疫性血小板减少症。
Cureus. 2023 May 3;15(5):e38509. doi: 10.7759/cureus.38509. eCollection 2023 May.
8
Babesiosis and hemophagocytic syndrome in an asplenic renal transplant recipient.一位无脾肾移植受者的巴贝斯虫病和噬血细胞综合征
Transplantation. 1996 Aug 27;62(4):537-9. doi: 10.1097/00007890-199608270-00018.
9
Atraumatic splenic rupture from Babesia: A disease of the otherwise healthy patient.巴贝斯虫所致的非创伤性脾破裂：一种见于原本健康患者的疾病。
Ticks Tick Borne Dis. 2015 Jul;6(5):649-52. doi: 10.1016/j.ttbdis.2015.05.010. Epub 2015 Jun 12.
10
Autoimmune Hemolytic Anemia as Presenting Symptom of Hodgkin Lymphoma.自身免疫性溶血性贫血作为霍奇金淋巴瘤的首发症状
Case Rep Hematol. 2021 Mar 31;2021:5580823. doi: 10.1155/2021/5580823. eCollection 2021.
引用本文的文献
1
Babesiosis-induced warm autoimmune hemolytic anemia, from infection to hemolysis: a case report.巴贝斯虫病诱发的温抗体型自身免疫性溶血性贫血：从感染到溶血的病例报告
J Med Case Rep. 2025 Aug 11;19(1):400. doi: 10.1186/s13256-025-05466-x.
2
Hard Ticks as Vectors: The Emerging Threat of Tick-Borne Diseases in India.硬蜱作为媒介：印度蜱传疾病的新威胁。
Pathogens. 2024 Jul 2;13(7):556. doi: 10.3390/pathogens13070556.
3
Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections.长疗程与短疗程脉冲高剂量氨苯砜联合疗法治疗慢性莱姆病/莱姆病治疗后综合征合并巴尔通体病及相关混合感染的疗效比较
Microorganisms. 2023 Sep 12;11(9):2301. doi: 10.3390/microorganisms11092301.
4
Characterization of anti-erythrocyte and anti-platelet antibodies in hemolytic anemia and thrombocytopenia induced by spp. and spp. infection in mice.鉴定 spp. 和 spp. 感染诱导的溶血性贫血和血小板减少症小鼠中抗红细胞和抗血小板抗体。
Front Cell Infect Microbiol. 2023 Apr 14;13:1143138. doi: 10.3389/fcimb.2023.1143138. eCollection 2023.
5
Pathogenesis of Anemia in Canine Babesiosis: Possible Contribution of Pro-Inflammatory Cytokines and Chemokines-A Review.犬巴贝斯虫病贫血的发病机制：促炎细胞因子和趋化因子的可能作用——综述
Pathogens. 2023 Jan 20;12(2):166. doi: 10.3390/pathogens12020166.
6
Anaemia in Sheep Caused by and Haemoparasites.由血液寄生虫引起的绵羊贫血
Animals (Basel). 2022 Nov 29;12(23):3341. doi: 10.3390/ani12233341.
7
induced fulminant sepsis in an immunocompromised host: A case report and the case-specific literature review.免疫功能低下宿主中的诱导性暴发性败血症：病例报告及针对该病例的文献综述
Open Life Sci. 2022 Sep 14;17(1):1200-1207. doi: 10.1515/biol-2022-0448. eCollection 2022.
8
The Cross-Species Immunity During Acute Co-Infection in Mice.急性混合感染期间小鼠的跨种属免疫。
Front Cell Infect Microbiol. 2022 May 27;12:885985. doi: 10.3389/fcimb.2022.885985. eCollection 2022.
9
Heme stimulates platelet mitochondrial oxidant production to induce targeted granule secretion.血红素刺激血小板线粒体产生氧化剂以诱导靶向颗粒分泌。
Redox Biol. 2021 Dec 5;48:102205. doi: 10.1016/j.redox.2021.102205.
10
Severe babesiosis with associated splenic infarcts and asplenia.伴有脾梗死和无脾症的重症巴贝斯虫病。
Proc (Bayl Univ Med Cent). 2021 Jun 1;34(5):597-599. doi: 10.1080/08998280.2021.1930632. eCollection 2021 Sep.
本文引用的文献
1
Post-Babesiosis Warm Autoimmune Hemolytic Anemia.巴贝虫病后自身免疫性溶血性贫血。
N Engl J Med. 2017 Mar 9;376(10):939-946. doi: 10.1056/NEJMoa1612165.
2
Babesiosis-associated immune thrombocytopenia.巴贝斯虫病相关免疫性血小板减少症
Stem Cell Investig. 2017 Jan 17;4:1. doi: 10.21037/sci.2017.01.02. eCollection 2017.
3
Hemophagocytic lymphohistiocytosis: macrophages engulfing red cells and neutrophils.
Stem Cell Investig. 2015 Mar 20;2:5. doi: 10.3978/j.issn.2306-9759.2015.02.02. eCollection 2015.
4
Clinicopatho-Biochemical Alterations Associated with Subclinical Babesiosis in Dairy Animals.与奶牛亚临床巴贝斯虫病相关的临床病理生化改变
J Arthropod Borne Dis. 2016 Jan 5;10(2):258-66. eCollection 2016 Jun.
5
Haematologic complications from human babesiosis: a case report.
New Microbes New Infect. 2015 Oct 23;8:148-9. doi: 10.1016/j.nmni.2015.10.008. eCollection 2015 Nov.
6
Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: A Review.莱姆病、人粒细胞无形体病和巴贝斯虫病的诊断、治疗与预防：综述
JAMA. 2016 Apr 26;315(16):1767-77. doi: 10.1001/jama.2016.2884.
7
Persistence of babesiosis for >2 years in a patient on rituximab for rheumatoid arthritis.一名类风湿关节炎患者在使用利妥昔单抗治疗期间，巴贝斯虫病持续超过2年。
Diagn Microbiol Infect Dis. 2016 Jun;85(2):231-2. doi: 10.1016/j.diagmicrobio.2016.02.016. Epub 2016 Feb 21.
8
Blood film findings in severe babesiosis.重症巴贝斯虫病的血涂片检查结果
Br J Haematol. 2016 Mar;172(6):839. doi: 10.1111/bjh.13845. Epub 2015 Nov 16.
9
Comparison of a quantitative PCR assay with peripheral blood smear examination for detection and quantitation of Babesia microti infection in humans.定量聚合酶链反应检测法与外周血涂片检查法在检测和定量人体微小巴贝斯虫感染中的比较
Diagn Microbiol Infect Dis. 2015 Jun;82(2):109-13. doi: 10.1016/j.diagmicrobio.2015.03.010. Epub 2015 Mar 18.
10
Profound autoimmune hemolysis and Evans syndrome in two asplenic patients with babesiosis.两名患有巴贝斯虫病的无脾患者发生严重自身免疫性溶血和伊文氏综合征。
Transfusion. 2015 Mar;55(3):661-5. doi: 10.1111/trf.12901. Epub 2014 Oct 29.
Zotero 插件