中国 PNH 患者感染 SARS-CoV-2 奥密克戎后严重溶血加重。
Severe hemolytic exacerbations of Chinese PNH patients infected SARS-CoV-2 Omicron.
机构信息
Key Laboratory of Hematology of Nanjing Medical University, Department of Hematology, Collaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China.
Department of Hematology, The Second People's Hospital of Lianyungang, Lianyungang, Jiangsu, China.
出版信息
Immun Inflamm Dis. 2023 Aug;11(8):e966. doi: 10.1002/iid3.966.
INTRODUCTION
Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by hemolytic anemia, bone marrow failure, thrombophilia. COVID-19, caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with many variants including Omicron.
METHODS
This study collected demographic and clinical data of 20 PNH patients with SARS-CoV-2 Omicron infection.
RESULTS
They all were with high disease activity, and LDH level exceeded any documented since the diagnosis of PNH, and those reported in the literature for previously stable treatment with complement inhibitors. D-dimer level elevated in 10 patients. 2 patients developed mild pulmonary artery hypertension. Glomerular filtration rate declined in 5 patients. 1 patient developed acute renal failure and underwent hemodialysis. Anemia and hemolysis were improved in 5 patients treated with eculizumab.
CONCLUSIONS
Hemolytic exacerbation of PNH with COVID-19 is severe and eculizumab may be an effective treatment.
简介
阵发性夜间血红蛋白尿症（PNH）的特征是溶血性贫血、骨髓衰竭、血栓形成倾向。由新型严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的 COVID-19，有许多变体，包括奥密克戎。
方法
本研究收集了 20 例感染 SARS-CoV-2 奥密克戎的 PNH 患者的人口统计学和临床数据。
结果
他们的疾病活动度均较高，LDH 水平超过了 PNH 诊断以来的任何记录，也超过了文献中先前使用补体抑制剂稳定治疗的记录。10 例患者的 D-二聚体水平升高。2 例患者出现轻度肺动脉高压。5 例患者肾小球滤过率下降。1 例患者发生急性肾衰竭并接受血液透析。5 例接受依库珠单抗治疗的患者贫血和溶血得到改善。
结论
COVID-19 导致的 PNH 溶血加重较为严重，依库珠单抗可能是一种有效的治疗方法。
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