Mickley H, Sørensen P G
Scand J Haematol. 1984 Mar;32(3):323-6. doi: 10.1111/j.1600-0609.1984.tb01698.x.
A case of severe immune haemolytic anaemia in a 54-year-old man suffering from Mycoplasma pneumonia is presented. A strongly positive direct Coombs test with erythrocyte bound IgG, C3d and C4 was demonstrated during the haemolytic process. Further, serologic investigations revealed ampicillin-dependent 'warm' antibodies and a cold agglutinin titre greater than 2000. No firm conclusion can be drawn as to which antibody caused the haemolysis. Treatment including withdrawal of antibiotics, blood transfusions (washed red cells, concentrated erythrocyte suspension) and corticosteroids was successful. It is suggested that tests should be carried out for erythrocyte bound drug-induced antibodies in cases of haemolysis with a history of drug exposure.
本文报告了一例54岁患支原体肺炎男性的严重免疫性溶血性贫血病例。在溶血过程中，直接抗人球蛋白试验显示红细胞结合IgG、C3d和C4呈强阳性。此外，血清学检查发现了氨苄西林依赖性“温性”抗体，冷凝集素效价大于2000。关于哪种抗体导致溶血，尚无确凿结论。包括停用抗生素、输血（洗涤红细胞、浓缩红细胞悬液）和使用皮质类固醇在内的治疗取得了成功。建议在有药物暴露史的溶血病例中检测红细胞结合的药物诱导抗体。
