Center for Pediatric Allergy and Rheumatology, KKR Sapporo Medical Center, Sapporo, Japan.
Mod Rheumatol Case Rep. 2020 Jan;4(1):99-101. doi: 10.1080/24725625.2019.1681654. Epub 2019 Nov 5.
Intravenous immunoglobulin (IVIG) is a standard therapy for Kawasaki disease (KD), because it prevents formation of coronary artery aneurysm, a major complication of KD. Herein, we report a 3-year-old boy with KD complicated by haemolytic anaemia (HA) which developed following two courses of IVIG. Although both direct and indirect antiglobulin tests and anti-M antibodies were positive in his blood obtained after the onset of HA, indirect antiglobulin tests and anti-M antibodies were negative either in the blood sample before the treatment or the same lot of IVIG products as those used for the therapy, suggesting autoimmune mechanism. This is, to our knowledge, the first report of autoimmune HA caused by anti-M autoantibodies after IVIG therapy in KD.
静脉注射免疫球蛋白（IVIG）是川崎病（KD）的标准治疗方法，因为它可以预防冠状动脉瘤的形成，这是 KD 的主要并发症。在此，我们报告了一例 3 岁男孩 KD 合并溶血性贫血（HA），在接受两次 IVIG 治疗后发生。尽管在 HA 发病后获得的血液中直接和间接抗球蛋白试验以及抗-M 抗体均为阳性，但在治疗前的血液样本或与用于治疗的同一批 IVIG 产品中，间接抗球蛋白试验和抗-M 抗体均为阴性，提示为自身免疫机制。据我们所知，这是首例 KD 患者在 IVIG 治疗后由抗-M 自身抗体引起的自身免疫性 HA 报告。
