Sugisaki Manato, Ishizaki Takuma, Iriuchishima Hirono, Shimizu Hiroaki, Yanagisawa Kunio, Ogawa Yoshiyuki, Yokohama Akihiko, Saitoh Takayuki, Tsukamoto Norifumi, Handa Hiroshi
Department of Hematology, Gunma University Graduate School of Medicine.
Blood Transfusion Services, Gunma University Hospital.
Rinsho Ketsueki. 2019;60(8):924-928. doi: 10.11406/rinketsu.60.924.
A 32-year-old woman was diagnosed with autoimmune hemolytic anemia (AIHA) at 12 weeks of a pregnancy examination and followed up closely without treatment. At 40 weeks of gestation, she underwent emergency caesarean section because of premature rupture. On postoperative day one, the patient exhibited worsening hemolysis and tachycardia and developed high-output heart failure; she was diagnosed with Basedow disease based on the tachycardia pattern and thyroid storm based on the presence of hyperthyroidism, fever, tachycardia, and heart failure. She was administered thiamazole and potassium iodide, which improved her thyroid function, hemolytic anemia, and heart failure. AIHA is rarely associated with Basedow disease, and hemolytic anemia can be aggravated by hyperthyroidism. In pregnant women with AIHA, management of hyperthyroidism is crucial as delivery can lead to thyroid storm.
一名32岁女性在孕期检查12周时被诊断为自身免疫性溶血性贫血（AIHA），未接受治疗并密切随访。妊娠40周时，因胎膜早破接受急诊剖宫产。术后第1天，患者溶血加重、心率加快，并发高输出量心力衰竭；根据心动过速模式诊断为Graves病，根据存在甲状腺功能亢进、发热、心动过速和心力衰竭诊断为甲状腺危象。给予她甲巯咪唑和碘化钾治疗，甲状腺功能、溶血性贫血和心力衰竭均得到改善。AIHA很少与Graves病相关，甲状腺功能亢进可加重溶血性贫血。对于患有AIHA的孕妇，控制甲状腺功能亢进至关重要，因为分娩可能导致甲状腺危象。
