孕期轻度β地中海贫血患者的直接抗球蛋白试验阴性自身免疫性溶血性贫血：一例报告
Direct antiglobulin test-negative autoimmune hemolytic anemia in a patient with β-thalassemia minor during pregnancy: A case report.
作者信息
Zhou Yang, Ding Yi-Ling, Zhang Li-Juan, Peng Mei, Huang Jian
机构信息
Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.
出版信息
World J Clin Cases. 2022 Feb 6;10(4):1388-1393. doi: 10.12998/wjcc.v10.i4.1388.
BACKGROUND
Severe refractory anemia during pregnancy can cause serious maternal and fetal complications. If the cause cannot be identified in time and accurately, blind symptomatic support treatment may cause serious economic burden. Thalassemia minor pregnancy is commonly considered uneventful, and the condition of anemia rarely progresses during pregnancy. Autoimmune hemolytic anemia (AIHA) is rare during pregnancy with no exact incidence available.
CASE SUMMARY
We report the case of a 30-year-old β-thalassemia minor multiparous patient experiencing severe refractory anemia throughout pregnancy. We monitored the patient closely, carried out a full differential diagnosis, made a diagnosis of direct antiglobulin test-negative AIHA, and treated her with prednisone and intravenous immunoglobulin. The patient gave birth to a healthy full-term baby.
CONCLUSION
Coombs-negative AIHA should be suspected in cases of severe hemolytic anemia in pregnant patients with and without other hematological diseases.
背景
妊娠期重度难治性贫血可导致严重的母婴并发症。若不能及时准确查明病因，盲目进行对症支持治疗可能会造成沉重的经济负担。轻度地中海贫血妊娠通常被认为情况平稳，孕期贫血状况很少进展。自身免疫性溶血性贫血（AIHA）在孕期罕见，尚无确切发病率数据。
病例摘要
我们报告一例30岁的轻度β地中海贫血经产妇病例，该患者在整个孕期均患有严重难治性贫血。我们对患者进行密切监测，进行全面鉴别诊断，诊断为直接抗人球蛋白试验阴性的AIHA，并给予泼尼松和静脉注射免疫球蛋白治疗。患者产下一名健康足月婴儿。
结论
对于患有或未患有其他血液系统疾病的妊娠患者出现严重溶血性贫血的情况，应怀疑存在库姆斯阴性AIHA。
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