Gupta Mridul, Singh Divita, Lee Patrick, Kadiyam Sandhya
Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA.
Ambulatory Care Pharmacy Resident, University of Florida, Gainesville, Florida, USA.
Case Rep Hematol. 2019 Jan 9;2019:2089359. doi: 10.1155/2019/2089359. eCollection 2019.
Internal watershed infarcts (WI) involve white matter between deep and superficial arterial systems of middle cerebral artery. These infarcts are considered to be either from low blood flow or microembolism. Anemia is an extremely rare cause of watershed infarcts. Very few cases of hemolytic anemia causing watershed cerebral infarcts have been reported. Chronic lymphocytic leukemia (CLL) is frequently complicated with secondary autoimmune cytopenia such as autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), and pure red cell aplasia. AIHA is present in about 7-10% of patients with CLL. AIHA from CLL presenting as WI is an extremely rare phenomenon with no previously published case reports to the best of our knowledge.
脑内分水岭梗死（WI）累及大脑中动脉深、浅动脉系统之间的白质。这些梗死被认为是由低血流或微栓塞引起的。贫血是分水岭梗死极为罕见的病因。很少有溶血性贫血导致分水岭脑梗死的病例报道。慢性淋巴细胞白血病（CLL）常并发继发性自身免疫性血细胞减少，如自身免疫性溶血性贫血（AIHA）、免疫性血小板减少症（ITP）和纯红细胞再生障碍。约7%-10%的CLL患者存在AIHA。据我们所知，CLL所致AIHA表现为WI是一种极其罕见的现象，此前尚无病例报告发表。
