Department of Blood Transfusion, and Department of Clinical Laboratory Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
Department of Clinical Laboratory Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Ann Clin Lab Sci. 2021 Mar;51(2):213-219.
Patients with warm autoimmune hemolytic anemia (WAIHA) present with anemia that is highly heterogeneous, and often have macrocytic anemia with inappropriately elevated mean corpuscular volume (MCV). The goal of this retrospectivecase study is to elucidate the characteristics of anemia in patients with idiopathic WAIHA.
The hematological parameters were analyzed by automated hematology analyzers in 19 consecutive patients with idiopathic WAIHA. Thecontent of hemoglobin (Hb) in the reticulocytes was assessed as reticulocyte Hb equivalent (RET-He). Relevant laboratory data and medical records were retrospectively studied.
The median MCV was 102.7 fL and ten patients had macrocytic anemia with MCV above 100 fL. There was a significant correlation between the percentage of reticulocytes and MCV. The median RET-He value was 35.9 pg, and the reticulocytes of patients with higher MCV had higher RET-He. There was a significant correlation between red cell volume distribution width (RDW) andMCV, while the association between RDW and RET-He was not significant. Red blood cell agglutination was not seen in any of the patients. Relative folate deficiency was implied to contribute to the increased Hb content in the reticulocytes of WAIHA patients.
Reticulocytes in WAIHA patients often contain more Hb than normal reticulocytes and become inappropriately large, possibly due to relative folate deficiency. Elevated MCV in WAIHA patients is due to the increase in both the number and the Hb content of reticulocytes.
患有温抗体自身免疫性溶血性贫血（WAIHA）的患者表现出高度异质性的贫血，通常伴有巨幼细胞性贫血和不适当升高的平均红细胞体积（MCV）。本回顾性病例研究的目的是阐明特发性 WAIHA 患者贫血的特征。
通过自动血液学分析仪分析了 19 例特发性 WAIHA 患者的血液学参数。通过网织红细胞血红蛋白当量（RET-He）评估网织红细胞中血红蛋白（Hb）的含量。回顾性研究了相关实验室数据和病历。
MCV 的中位数为 102.7 fL，10 例患者的 MCV 大于 100 fL，表现为巨幼细胞性贫血。网织红细胞百分比与 MCV 之间存在显著相关性。RET-He 值的中位数为 35.9 pg，MCV 较高的患者的网织红细胞具有较高的 RET-He。红细胞体积分布宽度（RDW）与 MCV 之间存在显著相关性，而 RDW 与 RET-He 之间的相关性不显著。患者中均未出现红细胞凝集。提示相对叶酸缺乏可能导致 WAIHA 患者网织红细胞中 Hb 含量增加。
WAIHA 患者的网织红细胞通常比正常网织红细胞含有更多的 Hb，并变得不适当的大，可能是由于相对叶酸缺乏。WAIHA 患者的 MCV 升高是由于网织红细胞数量和 Hb 含量的增加。
