Markus H, Forfar J C
Br Med J (Clin Res Ed). 1986 Oct 4;293(6551):839-40. doi: 10.1136/bmj.293.6551.839.
An elderly man with severe congestive heart failure was noted to have a haemoglobin concentration of 87 g/l and a reticulocyte count of 13%. Direct Coombs test yielded a positive result and the serum contained a moderate amount of warm antibody (IgG class). Steroids were given, but to no avail, and the patient's condition precluded splenectomy. A course of splenic irradiation was therefore tried (midline dose 2000 cGy (rads)), and 60 days later the blood film showed similar appearances to those in patients treated successfully by splenectomy. Haemoglobin concentration subsequently rose to normal. Splenic irradiation may offer a simple treatment for resistant warm autoimmune haemolytic anaemia when splenectomy is contraindicated.
一名患有严重充血性心力衰竭的老年男性，血红蛋白浓度为87 g/l，网织红细胞计数为13%。直接抗人球蛋白试验结果呈阳性，血清中含有中等量的温抗体（IgG类）。给予了类固醇治疗，但无效，且患者的病情不适合进行脾切除术。因此尝试了一个疗程的脾脏照射（中线剂量2000 cGy（拉德）），60天后血涂片显示的外观与脾切除术后成功治疗的患者相似。血红蛋白浓度随后升至正常。当脾切除术禁忌时，脾脏照射可能为难治性温抗体自身免疫性溶血性贫血提供一种简单的治疗方法。
