Hamilton H E, Morgan D P, Simmons A
Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City 52242.
Environ Res. 1978 Oct;17(2):155-64. doi: 10.1016/0013-9351(78)90018-x.
The unusual presentation of a factory worker with severe hemolytic anemia which remitted following splenectomy prompted a search for an environmental cause for red cell injury. The investigation showed the presence of an immunoglobulin in the patient's serum and on the red cells and small amounts of complement on red cells. The patient's serum caused agglutination of a normal person's red cells only when dieldrin-coated, a reaction blocked by first reacting the serum with dieldrin. The spleen of the patient had a greater than normal concentration of dieldrin, the source of dieldrin being dietary. It is concluded that dieldrin became immunogenic and provoked a chemical immunohemolytic anemia. The spleen played a major role in destruction of red cells injured by the immunopathic process and in accumulation of the antigenic substance dieldrin.
一名工厂工人出现严重溶血性贫血，脾切除术后病情缓解，这种不寻常的表现促使人们寻找红细胞损伤的环境原因。调查发现患者血清和红细胞中存在一种免疫球蛋白，红细胞上有少量补体。仅当用狄氏剂包被正常人的红细胞时，患者血清才会导致其凝集，而血清先与狄氏剂反应可阻断该反应。患者脾脏中狄氏剂浓度高于正常水平，狄氏剂来源为饮食。结论是狄氏剂具有免疫原性，引发了化学性免疫性溶血性贫血。脾脏在破坏受免疫病理过程损伤的红细胞以及在抗原物质狄氏剂的蓄积中起主要作用。
