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与新型冠状病毒相关的血清学血型不符及冷凝集素自身免疫性溶血性贫血

Serological Blood Group Discrepancy and Cold Agglutinin Autoimmune Hemolytic Anemia Associated With Novel Coronavirus.

作者信息

Raghuwanshi Babita

机构信息

Pathology- Transfusion Medicine, All India Institute of Medical Sciences, Bhopal, IND.

出版信息

Cureus. 2020 Nov 15;12(11):e11495. doi: 10.7759/cureus.11495.

Abstract

A case of a 45-year-old male presentation with viral pneumonia with anemia and thrombocytopenia and was admitted to COVID-19 ICU. The blood bank encountered a discrepancy in blood grouping and cross-match, which were subsequently resolved. The patient presented to the emergency room with fever and shortness of breath. He had tachycardia, fever, and had an oxygen saturation of 88% on room air. His SARS-CoV-2 RT-PCR test was positive. Total and unconjugated bilirubin was raised. Due to the anemia and falling haemoglobin, he was not started on any anticoagulation. On investigation, the patient's direct Antiglobulin test was positive. Cold agglutinin titer at 4-degree Celsius was 64. The blood sample showed auto agglutination at collection and discrepancy in blood grouping and cross-matching, which were subsequently resolved. As observed in this case report, COVID-19 infection can be associated with cold agglutinin disease and Autoimmune hemolytic anemia, and cold agglutinins should be recognized as potentially significant due to interference with laboratory investigations and complications associated with COVID 19.

摘要

一名45岁男性因病毒性肺炎伴贫血和血小板减少症入院,住进了COVID-19重症监护病房。血库在血型鉴定和交叉配血时遇到差异,随后得以解决。该患者因发热和呼吸急促被送往急诊室。他有心动过速、发热,在室内空气中氧饱和度为88%。他的SARS-CoV-2逆转录聚合酶链反应检测呈阳性。总胆红素和非结合胆红素升高。由于贫血和血红蛋白下降,未对他进行任何抗凝治疗。经检查,患者的直接抗球蛋白试验呈阳性。4摄氏度时冷凝集素效价为64。血样在采集时出现自身凝集,血型鉴定和交叉配血存在差异,随后得以解决。如本病例报告所示,COVID-19感染可能与冷凝集素病和自身免疫性溶血性贫血有关,由于冷凝集素会干扰实验室检查以及与COVID-19相关的并发症,应认识到其潜在的重要性。

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本文引用的文献

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Autoimmune hemolytic anemia.自身免疫性溶血性贫血
Am J Hematol. 2002 Apr;69(4):258-71. doi: 10.1002/ajh.10062.

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