直接抗人球蛋白试验阴性的自身免疫性溶血性贫血合并肺结核：一项诊断挑战。
Direct antibody test negative autoimmune hemolytic anemia with pulmonary tuberculosis: A diagnostic challenge.
作者信息
Sheetal Agarwal, Ruby Singh, Dhirendra P Singh, Anubhav Gupta, Devki Nandan
机构信息
Department of Pediatrics, Division of Pediatric Pulmonology and Intensive Care, ABVIMS and Dr. RML Hospital, New Delhi, India.
Department of Pediatrics, ABVIMS and Dr. RML Hospital, New Delhi, India.
出版信息
Asian J Transfus Sci. 2022 Jul-Dec;16(2):280-282. doi: 10.4103/ajts.AJTS_75_20. Epub 2022 May 26.
Tuberculosis (TB) has varied manifestations, but autoimmune hemolytic anemia (AIHA) due to TB is rare. Direct antibody test (DAT) or Coombs negative AIHA is also rare. We report a case of a 14-year-old boy who presented with hemolytic anemia and pneumonia. The Coombs test was repeatedly negative. After ruling out the possible infectious and noninfectious causes by extensive investigations, he was diagnosed as DAT-negative AIHA by monospecific antibody test with 4°C low ionic strength saline washes and column agglutination method which revealed the presence of IgG-2+ antibodies. Bronchoalveolar lavage fluid for acid-fast bacilli and gene Xpert was also positive. It is important to recognize TB as a cause of AIHA in South Asian countries where its incidence is high.
肺结核（TB）有多种表现形式，但由结核病引起的自身免疫性溶血性贫血（AIHA）较为罕见。直接抗人球蛋白试验（DAT）或库姆斯阴性的AIHA也很罕见。我们报告一例14岁男孩，他表现为溶血性贫血和肺炎。库姆斯试验反复呈阴性。通过广泛检查排除了可能的感染性和非感染性病因后，采用4℃低离子强度盐水洗涤和柱凝集法进行单特异性抗体检测，结果显示存在IgG-2+抗体，据此他被诊断为DAT阴性的AIHA。支气管肺泡灌洗 fluid 检测抗酸杆菌和基因Xpert也呈阳性。在结核病发病率较高的南亚国家，认识到结核病是AIHA的病因很重要。 （注：原文中“Bronchoalveolar lavage fluid”表述不太准确，可能是“Bronchoalveolar lavage”，即支气管肺泡灌洗）
Zotero 插件