Idel'son L I, Guseĭnova L A, Pogorel'skaia E P, Aprosina Z G, Novokreshchennykh I I
Ter Arkh. 1985;57(7):66-70.
The authors describe 4 patients with grave aplastic anemia that developed after acute virus hepatitis. In two cases aplasia occurred at the icteric period of hepatitis, in one during convalescence, and in one 5 months after the recovery from hepatitis. The counter electrophoresis technique failed to reveal the Australian antigen in all the 4 cases. Ninety per cent of patients out of over 200 reported cases of aplastic anemia that developed after acute virus hepatitis died. Of the 4 cases followed up by the authors, 3 patients died. One of the female patients was subjected to splenectomy 3 weeks after the occurrence of grave aplasia with fatty bone marrow with a purpose of immunodepression. Splenectomy entailed a considerable decrease in hemorrhagic diathesis. Later on the patient was treated with caprine antilymphocytic globulin. At present the patient is in a state of remission. The problems of the pathogenesis of aplastic anemia following acute virus hepatitis and potentialities of the disease treatment are under discussion.
作者描述了4例急性病毒性肝炎后发生严重再生障碍性贫血的患者。2例再生障碍性贫血发生在肝炎黄疸期，1例发生在恢复期，1例在肝炎恢复后5个月发生。对流电泳技术在所有4例中均未检测到澳大利亚抗原。在200多例报告的急性病毒性肝炎后发生再生障碍性贫血的病例中，90%的患者死亡。作者随访的4例患者中，3例死亡。其中1例女性患者在发生严重再生障碍性贫血且骨髓呈脂肪化3周后接受了脾切除术，目的是进行免疫抑制。脾切除术后出血倾向明显减轻。后来该患者接受了山羊抗淋巴细胞球蛋白治疗。目前该患者处于缓解状态。文中对急性病毒性肝炎后再生障碍性贫血的发病机制问题及该病的治疗潜力进行了讨论。
