溶血性贫血:COVID-19的一个后果。
Haemolytic anaemia: a consequence of COVID-19.
作者信息
Jawed Memoona, Hart Elizabeth, Saeed Malik
机构信息
Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK
Acute Medicine, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, UK.
出版信息
BMJ Case Rep. 2020 Dec 10;13(12):e238118. doi: 10.1136/bcr-2020-238118.
A man in his early 50s presented with jaundice, mild shortness of breath on exertion and dark urine. He had had coryzal symptoms 2 weeks prior to admission. Medical history included obstructive sleep apnoea and hypertension. His initial blood tests showed a mild hyperbilirubinaemia and acute kidney injury stage 1. Chest X-ray and CT pulmonary angiogram were negative for features suggestive of COVID-19. He later developed a drop in haemoglobin and repeat bloods showed markedly raised lactate dehydrogenase and positive direct antiglobulin test. These results were felt to be consistent with a haemolytic anaemia. A nasopharyngeal swab came back positive for COVID-19. We suspect the cause of his symptoms was an autoimmune haemolytic anaemia secondary to COVID-19 which has recently been described in European cohorts.
一名50岁出头的男性出现黄疸、轻度劳力性呼吸急促和深色尿液。入院前2周他有感冒症状。病史包括阻塞性睡眠呼吸暂停和高血压。他最初的血液检查显示轻度高胆红素血症和急性肾损伤1期。胸部X线和CT肺动脉造影未发现提示新冠病毒病(COVID-19)的特征。他后来血红蛋白下降,复查血液显示乳酸脱氢酶显著升高且直接抗球蛋白试验呈阳性。这些结果被认为与溶血性贫血相符。鼻咽拭子新冠病毒病检测呈阳性。我们怀疑他症状的原因是继发于COVID-19的自身免疫性溶血性贫血,欧洲队列最近已有相关描述。