Ogihara T, Katoh H, Yoshitake H, Iyori S, Saito I
Department of Internal Medicine, Hiratsuka City Hospital, Japan.
Jpn J Med. 1987 Aug;26(3):401-3. doi: 10.2169/internalmedicine1962.26.401.
We describe a case of a 29-year-old man with hyperthyroidism associated with autoimmune hemolytic anemia and periodic paralysis. Euthyroidism, which was achieved by propylthiouracil, brought inhibition of hemolysis and amelioration of anemia in spite of continuously positive direct and indirect Coombs' tests. Neither adrenocortical steroid nor blood transfusion was administered. Since indirect monospecific Coombs' test was negative against anti-human complements serum, the membrane of red blood cells may be less fragile. This is one reason why hemolysis was inhibited by anti-hyperthyroid therapy only. This may indicate that the hyperdynamic circulatory state secondary to hyperthyroidism plays an important role in the destruction of red blood cells which were coated by anti-red blood cell antibody.
我们描述了一例29岁男性患者，患有甲状腺功能亢进症，伴有自身免疫性溶血性贫血和周期性麻痹。丙硫氧嘧啶使甲状腺功能恢复正常，尽管直接和间接抗人球蛋白试验持续呈阳性，但溶血得到抑制，贫血症状改善。未给予肾上腺皮质类固醇或输血治疗。由于间接单特异性抗人球蛋白试验对抗人补体血清呈阴性，红细胞膜可能较不易破碎。这是仅通过抗甲状腺治疗就能抑制溶血的原因之一。这可能表明，甲状腺功能亢进继发的高动力循环状态在被抗红细胞抗体包被的红细胞破坏中起重要作用。
