Ritch P S, Anderson T
Department of Medicine, Medical College of Wisconsin, Milwaukee.
Cancer. 1987 Dec 1;60(11):2637-40. doi: 10.1002/1097-0142(19871201)60:11<2637::aid-cncr2820601111>3.0.co;2-s.
An 85-year-old man with chronic lymphocytic leukemia developed severe warm antibody-type autoimmune hemolytic anemia. Initial therapy with high-dose corticosteroids had no discernible effect on the hemolytic process. Following treatment with high-dose intravenous immunoglobulin (0.4 g/kg/d for 5 consecutive days) there was an immediate and sustained increase in hematocrit accompanied by a progressive decline in reticulocyte count. A review of the literature reveals that some patients with steroid-resistant immune hemolysis may benefit from high-dose immunoglobulin. This approach should be considered in elderly patients with severe anemia whose medical status precludes splenectomy.
一名85岁的慢性淋巴细胞白血病男性患者出现了严重的温抗体型自身免疫性溶血性贫血。初始使用大剂量皮质类固醇治疗对溶血过程没有明显效果。在接受大剂量静脉注射免疫球蛋白治疗（连续5天，0.4 g/kg/天）后，血细胞比容立即且持续升高，同时网织红细胞计数逐渐下降。文献回顾显示，一些对类固醇耐药的免疫性溶血患者可能从大剂量免疫球蛋白中获益。对于因身体状况不适合行脾切除术的重度贫血老年患者，应考虑这种治疗方法。
